Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what his policy is on (a) doctors and (b) other qualified medical personnel administering pain-relieving drugs which may shorten lives; and whether regulations on that issue changed after the conviction of Harold Shipman.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
A wide variety of medicines are used for the purpose of pain-relief, and they have differing levels of regulation. Some items can be bought off-the-shelf without a prescription, whilst others require authorisation from a medical professional. The Human Medicines Regulations 2012 set out the responsibilities which certain medical professionals may undertake regarding the supply and administration of regulated medicines. The Misuse of Drugs Act 1971 sets out the legal framework for the prevention of misuse of controlled drugs.
Decisions about what medicines to prescribe and administer are made by the doctor or other qualified medical personnel responsible for that part of the patient’s care. They must always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed and administered, and they must take account of appropriate national guidance on clinical effectiveness. Clinicians are responsible for the decisions they make regarding the administration of medicines, and they are regulated by the relevant regulatory body for their profession.
Professional regulators are responsible for setting and enforcing their own standards for the healthcare professionals that they regulate. The General Medical Council (GMC) is the regulator of all medical doctors practising in the United Kingdom, and the Nursing and Midwifery Council (NMC) is the regulator of nurses and midwives in the UK. Both the GMC and the NMC are independent of the Government, are directly accountable to Parliament, and are responsible for operational matters concerning the discharge of their statutory duties.
Following the Shipman Inquiry's Fourth Report, published on 14 July 2004, the Government introduced tighter controls on the procurement, storage, supply and prescribing of controlled drugs, and established national and regional monitoring by the Care Quality Commission (CQC) and a network of regional NHS Controlled Drug Accountable Officers. The CQC is responsible for making sure that health and care service providers, and other regulators, maintain a safe environment for the management and use of controlled drugs in England. The CQC does this under the Controlled Drugs (Supervision of Management and Use) Regulations 2013. These regulations strengthened system governance to monitor the safe use and prescribing of controlled drugs, and require greater co-ordination between the health system and police, to investigate and take action, to protect patients and the public against the misuse and diversion of controlled drugs. Further information on these regulations is available at the following link:
https://www.legislation.gov.uk/uksi/2013/373/contents/made
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to extend the remit of the Care Quality Commission to include vision rehabilitation services for blind and partially sighted people.
Answered by Andrew Gwynne - Parliamentary Under-Secretary (Department of Health and Social Care)
Under the Care Act 2014, local authorities in England have a legal duty to support people with sight loss to develop practical skills and strategies to maintain independence.
The Care Quality Commission (CQC) is now assessing how local authorities are meeting the full range of their duties under Part 1 of the Care Act 2014. These assessments identify local authorities’ strengths and areas for development, facilitating the sharing of good practice and helping us to target support where it is most needed.
Therefore, although the CQC is not currently required to assess vision rehabilitation services as a regulated activity, under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, this does mean that sensory services, including vision rehabilitation, form part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement.
The CQC’s reports and ratings of local authorities are made public on their website.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he plans to take to ensure the availability of learning disability nursing studies programmes in the South East.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Individual universities are responsible for the courses that they offer. We have launched a 10-Year Health Plan to reform the National Health Service. A central and core part of this plan will be our workforce, and how we ensure we train and provide the staff the NHS needs, including doctors and nurses, to care for patients across our communities.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent estimate he has made of the number of NHS patients harmed by cobalt poisoning from modular neck hip replacements in each of the last three years.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medicines and Healthcare products Regulatory Agency (MHRA) is aware of concerns regarding modular neck hips and the risk of cobalt poisoning. We are investigating the issue with our stakeholders including the British Orthopaedic Association, British Hip Society, and the National Joint Registry to support.
The term modular neck covers a broad range of designs, and adverse incident reports of this sort typically include descriptions of symptoms rather than a definitive diagnosis of cobalt poisoning. In addition, it is not possible to uniquely identify cobalt poisoning from hip replacements in the ICD-10 coding scheme currently used in Hospital Episode Statistics.
The UK Medical Devices Regulations provide clear requirements for manufacturers to undertake post-market surveillance activities to ensure safety action is taken, when appropriate. The MHRA is working towards implementing a future regime for medical devices regulation. This will put in place strengthened legal requirements for how manufacturers monitor and report on their devices once they are being used in the real world.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, on what grounds a hospital can change its records regarding a patient's next of kin (a) after the patient has been admitted and (b) without the consent of the (i) patient and (ii) patient's next of kin as designated at the time of admission; and what processes are in place for (A) recording and (B) changing hospital records on a patient's next of kin.
Answered by Will Quince
National Health Service trusts may ask a patient to nominate their next of kin on admission to hospital. A hospital will not ordinarily change a patient’s next of kin unless the patient has requested this. In the event a patient does not have a next of kin, health professionals may use their discretion to liaise with family and friends to appoint one.
If it is an emergency and it is unclear who the patient’s next of kin is, and the patient is unable to communicate their choice, the hospital will normally seek advice from the person they believe is closest to the patient and allocate one. Where the next of kin has been changed, both the general practice and hospital records would be duly updated.
NHS England provides further information on amending patient and service user records, which is available at the following link:
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make it his policy to hold back the proposed sale by the NHS of the site and buildings of the Fenwick Hospital, Lyndhurst until (a) documentation is produced specifying (i) who owns the title and (ii) what the terms were under which the original gift of ownership to the Lyndhurst community came under control of the NHS in 1948 and (b) sufficient time has been given to the League of Friends of the Fenwick Hospital further to develop plans for its future and assemble financial support to implement them.
Answered by Will Quince
The future use of Fenwick Community Hospital is subject to the plans set out by Hampshire and Isle of Wight Integrated Care Board and NHS England and is not a matter for the Secretary of State for Health and Social Care.
Hampshire and Isle of Wight Integrated Care Board and NHS England have offered a meeting to League of Friends and Julian Lewis MP, in order that all information relating to the legal title of the Fenwick Hospital, Lyndhurst can be shared and discussed. Following this meeting, date to be confirmed, a decision relating to the auction sale of the site and its timing can be made.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many inpatient beds there were in NHS community hospitals in England in (a) 1997, (b) 2010 and (c) 2022; and if he will make an assessment of trends in inpatient capacity in those hospitals between those dates.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
NHS England holds data on the number of community rehab beds in England collected monthly through the NHS Capacity Tracker, but this data is not available in 1997 and 2010. Monthly data collection on community rehab beds started in 2020, from which point capacity has increased. The Capacity Tracker shows there were 7,062 community rehab beds in August 2020, rising to 7,629 in January 2022 and 7,999 in January 2023.
A community hospital is a service which offers integrated health and social care services in the community. Therefore ‘community hospital’ functions are carried out in a range of places including intermediate care and rehab settings and District General hospitals, not just in buildings called community hospitals. NHS England therefore define beds on function rather than on place or building.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the potential role of inpatient beds in community hospitals as step-down beds to release capacity in general hospitals; and how many inpatient beds there are in community hospitals in England.
Answered by Helen Whately - Shadow Secretary of State for Work and Pensions
In line with the ‘Home First’ approach, patients for whom care and assessment can safely be continued in a non-acute setting should be discharged to their own home or a community setting. We are providing an additional £200 million of funding specifically for short term care. This will accelerate discharge and free up hospital beds for those who need them.
Information on the number of inpatient beds in community hospitals is not available in the format requested.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if she will list the (a) NHS hospitals which contain dedicated centres for the removal of failed vaginal mesh and (b) dates on which those centres became operational.
Answered by Caroline Johnson - Shadow Minister (Health and Social Care)
The following National Health Service hospitals provide specialised services for patients with complications of mesh inserted for urinary incontinence and vaginal prolapse:
- Cambridge University Hospital NHS Foundation Trust;
- Manchester University NHS Foundation Trust;
- Newcastle Upon Tyne Hospitals NHS Foundation Trust;
- Nottingham University Hospitals NHS Trust;
- Sheffield Teaching Hospitals NHS Foundation Trust;
- University College Hospitals NHS Foundation Trust;
- University Hospitals of Leicester NHS Trust;
- University Hospital Southampton NHS Foundation Trust; and
- North Bristol NHS Foundation Trust.
University Hospital Southampton NHS Foundation Trust and North Bristol NHS Foundation Trust commenced delivery of services for the removal of failed vaginal mesh in November 2021 and April 2022 respectively. The remaining hospitals commenced delivery of services for the removal of failed vaginal mesh in April 2021.
Asked by: Julian Lewis (Conservative - New Forest East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, when he plans to substantively respond to Questions (a) 124936 on Surgical Mesh Implants: South East, due for Answer on 23 February, (b) 127247 on Medicines and Medical Devices Safety Independent Review, due for answer on 25 February and (c) 131025 on Members: Correspondence, seeking a response to a letter dated 6 December 2021 from the Rt hon. Member for New Forest East about a vulnerable constituent and due for answer on 3 March; for what reason none of the substantive answers have yet been forthcoming; and what steps he plans take to ensure that Questions receive a substantive answer on the date they are due.
Answered by Edward Argar - Shadow Secretary of State for Health and Social Care
I refer the Rt hon. Member to the answers to Questions 124936, 127247 and 131025.
We take parliamentary scrutiny incredibly seriously and it is fundamentally important that hon. Members are provided with accurate and timely information to enable them to hold the Government to account. We are working rapidly to provide all Members with accurate answers to their questions, while supporting the Government’s response to the COVID-19 pandemic.