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 and what proportion of PSA tests have (a) accurately diagnosed, and (b) given false (i) negative and (ii) positive diagnoses for prostate cancer in the most recent year for which figures are available.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Disease Registration Service (NDRS) in NHS England collects diagnosis and treatment data on cancer patients in England. NDRS does not hold information on the specific results of the prostate specific antigen test 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, what his policy is on (a) routine PSA testing for males in specific age categories and (b) the reimbursement of GP practices by the NHS for providing PSA tests; and whether he has made an assessment of the potential impact of existing funding arrangements for PSA tests on the willingness of GP practices to provide routine testing.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
There is no age limit on prostate specific antigen (PSA) tests.
Advice for general practitioners (GPs) called the Prostate Cancer Risk Management Programme provides information and guidance for GPs to counsel asymptomatic men about the potential benefits and harms of PSA testing so they can make an informed decision about whether to have the test. There is no routine testing of men using PSA. They are advised to follow National Institute for Health and Care Excellence (NICE) guidance for men who they think may have symptoms that could be prostate cancer. This includes the use of PSA as a diagnostic rather than screening test.
More information on the programme is available at the following link:
https://www.gov.uk/guidance/prostate-cancer-risk-management-programme-overview
With regards reimbursement of GP practices by the National Health Service for providing PSA tests, local enhanced services, such as blood tests, are negotiated and agreed locally, and are commissioned by integrated care boards to fit the needs of the local population. GP practices can choose whether they would like to participate in providing these services. These services can vary in scope and funding across the country. We have not assessed the potential impact of this funding arrangement for PSA tests on GP willingness to provide testing.
Where a man is symptomatic of prostate cancer, NICE guidance is clear about using the PSA test in these men. The guidance 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 take steps to (a) increase awareness of, (b) improve screening for and (c) develop research into lobular breast cancer; and what recent discussions his Department has had with NHS England on the (i) prevalence and (ii) detectability of this type of breast cancer.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
Improving the early diagnosis of cancer, including lobular breast cancer, is a priority for NHS England. The National Health Service will improve cancer survival rates and hit all NHS cancer waiting time targets, so that no patient waits longer than they should.
To increase awareness of lobular breast cancer, NHS England and other NHS organisations, nationally and locally, publish information on the signs and symptoms of breast cancer. Further information can be found on the NHS.UK website, which is available at the following link:
The NHS Breast Screening Programme offers all women in England between the ages of 50 and 71 years old the opportunity to be screened every three years for breast cancer, to help detect abnormalities and intervene early to reduce the number of lives lost to breast cancer. However, lobular breast cancer is difficult to detect using imaging scans, such as mammogram.
The Department invests £1.5 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR). NIHR research expenditure for all cancers was £133 million in 2023/24 reflecting its high priority.
The Department has invested £29 million into the Institute of Cancer Research and the Royal Marsden NIHR Biological Research Centre in 2022, supporting their efforts to strengthen research into cancer, including lobular breast cancer. Wider investments into breast cancer research include a £1.3 million project to determine whether an abbreviated form of breast magnetic resonance imaging can detect breast cancers missed by screening through mammography, including lobular breast cancer.
The Department continues to work closely with NHS England on the development of the National Cancer Plan to achieve the overall goal of fewer lives lost to cancer, including to lobular breast cancer. The plan will be published later this year.
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 designate a Minister in his Department to (a) have responsibility for the field of cell and gene therapies and (b) chair his Department's Advanced Therapies Medicinal Products Coordination Group.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
The Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health, Baroness Merron, is the Minister with responsibility for life sciences and innovation, and cell and gene therapies are included in this remit.
In September 2024, the Department stood up an advanced therapies co-ordination group which aims to create a joined-up ecosystem that will support the development, regulation, and delivery of advanced therapy medicinal products in the United Kingdom. This group is chaired at the Senior Civil Service Grade 1 level. We note the recent report from the Cell and Gene Collective, titled Tomorrow’s Science, Today’s NHS, including the ask for a Minister to chair the group, and we will consider the report’s recommendations in due course.
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 take steps to facilitate the circulation of material to General Practitioners advising how to (a) recognise and (b) treat with (i) antibiotics and (ii) anti-inflammatory medications the conditions of (A) Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and (B) Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS).
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) is the independent, expert body that develops evidence-based guidelines for the National Health Service on best practice. While the NICE currently has no plans to issue guidance on paediatric acute-onset neuropsychiatric syndrome (PANS) and paediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS), should the evidence base develop further, we would look to the NICE to update clinical policy.
In the meantime, integrated care systems are responsible for planning care for their populations’ conditions, and clinicians will want to take account of any new research and developments in guidance, such as those being overseen by the PANS PANDAS Steering Group, to ensure that they can continue to provide high quality care to their patients.
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 (a) mechanisms exist and (b) steps he is taking to ensure that integrated care boards are accountable for their commissioning of children’s palliative care.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
Integrated care boards (ICBs) are responsible for the commissioning of palliative and end of life care services, including for children and young people, to meet the needs of their local populations. To support ICBs in this duty, NHS England has published statutory guidance and service specifications.
NHS England has a legal duty to annually assess the performance of each ICB in respect of each financial year, and to publish a summary of its findings. This assessment must include how well the ICB has discharged its functions.
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 legal cases brought against the NHS by mesh-damaged women have been settled (a) in and (b) out of court in each of the past ten years.
Answered by Ashley Dalton - Parliamentary Under-Secretary (Department of Health and Social Care)
NHS Resolution (NHSR) manages clinical negligence and other claims against the National Health Service in England, and while the information is not available in the format requested, they have provided the data below. This information only covers England and not the rest of the United Kingdom, and NHSR has interpreted ‘in court’ as being where the court proceedings have been served, rather than where a case has gone to trial.
Claims notified and open are not guaranteed to be settled in the same year and can take many years to be concluded. Claims notified in any given year will often relate to incidents that have occurred many years prior. Claims closed and settled in one year will often relate to claims notified in different years. Many of the claims notified will have been repudiated and settled without damages paid.
It is also possible that the same claim may appear more than once in a dataset, across different year groups, for example, where the case has been closed as unsuccessful, challenged, reopened, and closed again at conclusion.
The following table shows the number of clinical claims and incidents received between the financial years 2014/15 and 2023/24, where the claim has been identified as a vaginal mesh claim:
Year of notification | Number of claims |
2014/15 | 5 |
2015/16 | 12 |
2016/17 | 15 |
2017/18 | 54 |
2018/19 | 70 |
2019/20 | 209 |
2020/21 | 396 |
2021/22 | 226 |
2022/23 | 166 |
2023/24 | 99 |
Total | 1,252 |
Source: NHSR
In addition, the following table shows the number of clinical claims settled between the financial years 2015/16 and 2023/24 with a damages payment, where the claim has been identified as a vaginal mesh claim, broken down by litigation status:
Year of settlement and litigation status | Number of claims |
2015/16 | # |
Litigation | # |
No Litigation | # |
2016/17 | # |
Litigation | # |
No Litigation | # |
2017/18 | 16 |
Litigation | 8 |
No Litigation | 8 |
2018/19 | # |
Litigation | 8 |
No Litigation | # |
2019/20 | # |
Litigation | 11 |
No Litigation | # |
2020/21 | 32 |
Litigation | 22 |
No Litigation | 10 |
2021/22 | 61 |
Litigation | 19 |
No Litigation | 42 |
2022/23 | 116 |
Litigation | 27 |
No Litigation | 89 |
2023/24 | 101 |
Litigation | 22 |
No Litigation | 79 |
Total | 356 |
Source: NHSR
Finally, the following table shows the number of clinical claims settled between the financial years 2015/16 and 2023/24 with no damages paid, where the claim has been identified as a vaginal mesh claim, broken down by litigation status:
Year of settlement and litigation status | Number of claims |
2015/16 | # |
Litigation | # |
No Litigation | 8 |
2016/17 | # |
Litigation | # |
No Litigation | 6 |
2017/18 | # |
Litigation | # |
No Litigation | 7 |
2018/19 | 43 |
Litigation | 5 |
No Litigation | 38 |
2019/20 | # |
Litigation | # |
No Litigation | 43 |
2020/21 | 90 |
Litigation | 6 |
No Litigation | 84 |
2021/22 | 167 |
Litigation | 64 |
No Litigation | 103 |
2022/23 | 179 |
Litigation | 28 |
No Litigation | 151 |
2023/24 | 120 |
Litigation | 10 |
No Litigation | 110 |
Total | 678 |
Source: NHSR
Notes: NHSR has supressed low figures as NHSR believe that disclosure of information to a member of the public would contravene one or more of the data protection principles. In some instances, for low numbers of claims, namely fewer than 5, in each category, the likelihood exists that individuals who are the subject of this information may be identified. As this information is sensitive personal data, NHSR believes it has a greater responsibility to protect those individuals’ identities, as disclosure could potentially cause damage and/or distress to those involved. Due to small numbers in the tables, NHSR has used a ‘#’ symbol in the relevant field.
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 publish current waiting lists totals at each of the mesh removal centres set up following the publication of the Cumberlege report; and whether mesh-damaged women are given an option to attend mesh removal centres other than ones led by surgeons who implanted their mesh originally.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Tackling waiting lists is a key part of our Health Mission and we are taking steps to return to the 18-week standard. The Elective Reform Plan sets out how the National Health Service will reform elective care services to meet the 18-week referral to treatment standard by March 2029.
There are nine specialist mesh centres across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team to ensure patients get access to the specialist care and treatment that they need, including pain management and psychological support. NHS England publishes data on referral to treatment waiting times, which is available at the following link:
https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/
Data is published at the level of specialties, for example gynaecology, and is not routinely published at sub-speciality level. The most recent waiting time data held by NHS England from 2024 indicated that the average waiting time across the nine centres was 28 weeks.
The surgery to remove mesh implanted for stress urinary incontinence and vaginal prolapse is a relatively new surgical discipline. Expertise is, therefore, concentrated in a limited number of specialist centres led by a core multi-disciplinary team, including consultant specialists in urogynaecology, urology, and pain management. Patients, when requesting treatment for mesh complications, can exercise patient choice and be referred to another centre, ensuring that they can be seen by another surgeon where appropriate.
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 take steps to commission (a) research into, and (b) training programmes for, improved techniques for removal of failed pelvic mesh implants from injured women including those removal methods developed in Missouri by Dr Dionysios Veronikis currently unavailable in the United Kingdom.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Department, through the National Institute for Health and Care Research (NIHR), is currently funding research to develop a patient-reported outcome measure (PROM) for prolapse, incontinence, and mesh complication surgery. This will enable women to self-report the ways in which any surgical treatment for these conditions, mesh and non-mesh related, has affected their quality of life. Once testing of the PROM is completed, women will be able to complete it as part of their care. It will also be suitable for use by national registries and with women taking part in clinical trials. The NIHR continues to welcome funding applications for research into any aspect of women’s health, including pelvic mesh.
NHS England has established nine specialist mesh centres across England, ensuring that women in every region with complications of mesh inserted for urinary incontinence and vaginal prolapse get the right support. Each mesh centre is led by a multi-disciplinary team to ensure patients get access to the specialist care and treatment that they need, including pain management and psychological support.
The National Health Service’s service specification sets out the standards of care expected from organisations funded by NHS England to provide specialised care. The specification for complications of mesh inserted for urinary incontinence, vaginal or internal, and external rectal prolapse states that specialised mesh centres must use trust appraisal systems to ensure that surgeons are appropriately trained, current in their practice, that they adhere to clinical and NICE guidance, comply with Pelvic Floor Registry data requirements, and report complications. The service specification 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, what his policy is on patient confidentiality in relation to sharing information on (a) inquiry reports and (b) other relevant information on killings by mentally ill people with the (i) families of their victims and (ii) general public; and what his policy is on (A) publishing independent homicide reports and (B) intervening to consider publication in such cases, in the context of patient confidentiality.
Answered by Stephen Kinnock - Minister of State (Department of Health and Social Care)
It is important that in such cases, National Health Service organisations are as transparent as possible within the bounds of the law, and that independent homicide reports are published and shared in line with legal guidance and with engagement from families. These decisions are for the organisations which commissioned the reports on a case-by-case basis.
In the case of the independent investigation into the care and treatment provided to Valdo Calocane, the NHS took the decision to publish the investigation’s report in full in line with the wishes of the families and given the level of detail already in the public domain.
The Department will work with NHS England and partners to set out next steps for how future independent mental health homicide reports should be published to ensure that NHS organisations act as transparently as possible, in line with their legal obligations.