Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the statement on the NHS webpage 'Can I access someone else's medical records (health records)?' that "children aged 12 or older are usually considered to have the capacity to give or refuse consent to parents requesting access to their health records, unless there is a reason to suggest otherwise".
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The Department and NHS England work closely together, in conjunction with a range of stakeholders across the sector, to make sure the National Health Service's position is right for children.
For children aged under 11 years old, parents are presumed to be exercising a child's right to access their records, where the child lacks capacity to exercise it on their own behalf. Children aged 11 years or older are usually considered to have the capacity to give or refuse consent to parents requesting access to their health records, unless there is a good reason to suggest otherwise.
Whilst reasonable efforts should be made to encourage the child to involve parents or guardians, children have the same rights of access and information as adults do. If a child has the capacity to give or withhold consent to the release of their health record information, health professionals should generally respect their wishes. General practice surgeries should have processes in place for determining on a case-by-case basis whether a child is competent to make this decision.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what assessment they have made of the article by the NHS Confederation Leading for all: supporting trans and non-binary healthcare staff, published in June; and what status that guidance has within the NHS.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
No specific assessment has been made. The guidance has not been issued by NHS England and it does not need to be followed by individual trusts. Whilst it is important we support staff working in the National Health Service, we also need to ensure that patients’ privacy and dignity is respected.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask His Majesty's Government whether, in light of the guidance on the NHS website under "Using linked profiles to access services for someone else", they are of the opinion that an 11-year-old child is able in all instances to deny their parents access to their medical records; and, if not, (1) what tests they expect a GP to apply in determining what information to withhold from parents, (2) whether this includes a test of Gillick competence, and (3) why these tests are not specified in the above notice so as to ensure that the process is transparent.
Answered by Lord Markham - Parliamentary Under-Secretary (Department of Health and Social Care)
The guidance states that when a child is aged between 11 and 16, they may be able to deny their parents proxy access to their online if the GP surgery agrees that is appropriate, and it is not intended that in all instances that would be appropriate. A GP surgery should have processes in place for determining whether a child aged between 11 and 16 years is competent to make this decision.
Specific tests are not described in the above guidance as each case must be considered individually with the interests of the child being paramount. There are no set questions to assess Gillick competency, but the professional bodies have guidance on this and the Frazer Guidelines.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what progress they are making towards the implementation of Surgical Hubs in England; and how are they administering the programme.
Answered by Lord Kamall
Following successful pilots in London, the National Health Service is now developing surgical hubs across the country. There are currently 44 stand-alone surgical hubs operational in England.
The additional £1.5 billion provided for the recovery of elective services includes funding for developing further surgical hubs. The Getting It Right First Time programme, in collaboration with NHS England and NHS Improvement, is providing guidance to systems and regions on how to use hubs effectively, standardise pathways and adopt best surgical practice. Systems and regions will submit bids to NHS England and NHS Improvement and this process will determine where hubs will be based.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by the Minister of State for Health on 27 October 2021 (59085), what are the (1) aims, and (2) scope, of the Pathway Redesign Programme.
Answered by Lord Kamall
The Pathway Redesign Programme aims to improve services and patient health outcomes and create additional capacity for elective care. This will release appointment times which can be used for urgent and new referrals and reduce waiting lists.
The programme will focus on redesigning some of the highest volume care pathways, such as optical care, cardiac and musculoskeletal services. Regional teams and integrated care systems will standardise ways of delivering care and adopt best practice, working with the Getting It Right First Time programmes and reduce any unwarranted variation.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the impact of the changes to the annual allowance for pensions in terms of (1) clinical hours worked, and (2) early retirement of senior doctors, over the past 10 years.
Answered by Lord Kamall
Since an individual may choose to reduce their working hours or take early retirement for a range of reasons it is not possible to isolate the impact of any single factor such as pension tax. We continue to monitor retirement patterns and hours worked by senior doctors.
The available evidence does not suggest any substantial change in consultant working hours. NHS Digital’s workforce statistics show the participation rate or average contracted hours per person has been stable for several years. Data from the NHS Business Services Authority, which administers the NHS Pension Scheme, shows that the number of consultants taking voluntary early retirement as a proportion of all consultant retirements has increased since 2012, although it has not changed significantly in more recent years.
The NHS Pension Scheme and well-remunerated careers mean that some senior doctors will amass a pension in excess of their allowances for tax-free pension saving. In 2020, the Government increased thresholds by £90,000 to remove all staff with threshold income below £200,000 from scope of the tapered annual allowance. An estimated 96% of general practitioners and 98% of consultants are out of scope of the taper based on their National Health Service earnings.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the practice of chest binding; and whether there are any restrictions on the advertising of chest binders.
Answered by Lord Kamall
No formal assessment has been made. The Advertising Standards Authority are responsible for the regulation of advertising in the United Kingdom. Their codes outline the standards which advertisers must adhere to when producing marketing or advertising content. Currently there are no formal restrictions for the restrictions on advertising of chest binding or products associated with chest binding.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government whether they intend the Unified Information Standard for Protected Characteristics to apply across government; and if so, how they intend to record a rape committed by a male who identifies as a woman with respect to (1) sex, and (2) gender identity.
Answered by Lord Bethell
We are discussing the options for implementing the recommendations with delivery partners and through appropriate stakeholder engagement.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what options they are considering for recording gender reassignment as part of the Unified Information Standard for Protected Characteristics; whether they are considering recording gender identity as part of that consideration; and if so, in what form.
Answered by Lord Bethell
We are discussing the options for implementing the recommendations with delivery partners and through appropriate stakeholder engagement.
Asked by: Lord Lucas (Conservative - Excepted Hereditary)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what options they are considering for recording sex as part of the Unified Information Standard for Protected Characteristics; and in particular, what consideration they are giving to those instances where sex may be hard to determine or non-standard in its expression.
Answered by Lord Bethell
We are discussing the options for implementing the recommendations with delivery partners and through appropriate stakeholder engagement.