Lord MacKenzie of Culkein

The UK Ship Register (UKSR) Advisory Panel Report, issued in May 2015, recommended that government review the regulations on the registration of ships under the UK Flag to identify changes which will attract ships to the UK Flag, without reducing standards.

An amending Statutory Instrument is currently in preparation to redefine the meaning of an “original document”, clarifying where hard copies of documents must be submitted to allow registration. This aims to improve efficiency within the registration process and enable the introduction of online registration.

Further opportunities to improve legislation in relation to ship registration will be considered as part the wider UKSR transformation programme. However, no proposals have yet been developed.

Officials continue to discuss with their counterparts in France and Norway the decision by those countries to discontinue Loran transmissions, to understand their reasoning and plans for the disused transmitters.

Her Majesty’s Government is researching terrestrial technology that could supply positioning, navigation and timing (PNT) needs. For example, Innovate UK is working with other agencies to research the use of quantum technology for PNT applications. In addition, there is research into technologies that supply only some elements of PNT, including ranging mode and radar absolute positioning.

There are no specific plans yet.

The Maritime and Coastguard Agency is currently recruiting a new Director of the UK Ship Register (UKSR) for whom an early task will be to review current regulations in light of the aspiration to grow the UKSR, and make any appropriate recommendations.

The number of ships over 100 GT on the UK register in 2005 and to date are detailed below. All totals were correct at 31st December in the respective year.

December 2005 1,438

December 2006 1,456

December 2007 1,481

December 2008 1,550

December 2009 1,553

December 2010 1,503

December 2011 1,469

December 2012 1,401

December 2013 1,360

December 2014 1,327

The figure for 2015 - 1,328 is up to and including 31st August.

The Government-funded Emergency Towing Vessel in Scotland provides coverage for both the Northern and Western Isles of Scotland. The Maritime and Coastguard Agency is not aware of any occasions where a casualty vessel in need of a tow around the Western Isles has not been provided with a successful and effective towage service. No ship has grounded or sunk, nor has there been any pollution caused by a lack of an available tow.

The Government will continue to keep the need for a towing capability under review as part of its assessment of spending priorities.

The Maritime and Coastguard Agency (MCA) is satisfied that the measures contained in the regulations proposed for revocation have been superseded by more modern and effective measures, including improved stability standards, and would not cause a deterioration of safety requirements. In addition, there is close oversight of the UK ferry industry by MCA Marine Surveyors to ensure that the circumstances leading to such an accident, such as the Sewol, would be extremely unlikely on a ferry on the UK flag.

The MCA is currently consulting on their proposal to revoke two sets of maritime safety regulations applying to roll-on roll-off passenger vessels which were introduced following the sinking of the Herald of Free Enterprise in 1987. That consultation will end on 10 August 2014.

It would be inappropriate to comment on whether the MCA will reconsider the proposal until that consultation has ended and they have analysed all responses.

There is no exemption in the EU Directive on sulphur content of marine fuels (Directive 2012/33/EU) that would allow the UK or other EU Member States to delay implementation. The timetable for applying the sulphur limits is also an integral part of Annex VI to the International Convention for the Prevention of Pollution from Ships (commonly known as MARPOL) and is therefore a binding obligation on states, such as the UK, which are parties to Annex VI.

In any event, introducing a delay at this stage could be extremely damaging for those shipowners and equipment manufacturers who have invested heavily on the basis that the new limit will come into force in January 2015. Moreover, a delay in implementation would mean a delay in obtaining the benefits to the UK, notably in terms of improved air quality, which will result from the new limit.

The maritime sector is vitally important to the UK economy and the Government is keen for talented individuals, trained to the highest standards, to continue to enter the industry. The Government produces and publishes National Statistics on the number of UK certificated seafarers and ratings currently estimated to be active at sea and on the number of sea cadets in training. The Department for Transport carefully monitors these statistics each year (or when updates are available).

It is evident that there is a decline in seafarer numbers and this was a key subject of discussion at a recent Maritime round table which included Ministers and representatives from industry and the Unions. To address this decline, the Support for Maritime Training programme (SMarT) budget was increased by 25% to £15m in September 2013. The SMarT budget supports the cost of training for both ratings and cadets.

The Government also has a number of other policies in place to address the decline including:

• Maritime apprenticeships, where the maritime sector is playing a key role in helping shape the future of apprenticeships through a ratings trailblazer which was announced in March 2014.

• The UK's tonnage tax regime has a mandatory training link where currently one trainee officer is trained each year for every 15 officer posts in a company or group's fleet. This training link will pilot an extension to allow three ratings to be trained in place of one trainee officer.

The Government is currently reviewing the application of the legislation to seafarers. The Department for Business, Innovation and Skills (BIS), where responsibility for the NMW legislation lies, are leading this review. It will primarily consider those seafarers working on ferry services. It is considering the Irish Sea routes as the maritime unions have raised concerns in regard to services on those routes. Other routes where potential avoidance or lack of awareness of the legislation is evident will be considered in due course.

Government, industry stakeholders and unions are working on this review.

The Maritime and Coastguard Agency (MCA) has a complement of 205 posts which either involve the physical activity of surveying, or where the job is graded at the same level as a surveyor. Of these posts, 24% are unfilled, although a high proportion are vacant because the postholder has been seconded or temporarily promoted to other roles which do not entail surveying. In these cases, their marine surveyor skills remain available to the MCA.

The MCA continues to campaign on a national basis to fill vacancies and the last campaign was launched in May 2014. Interviews are planned for week commencing 30 June.

The MCA is trialling Skype interviews to improve the accessibility for candidates working overseas or on vessels.

The MCA has been running a Graduate Scheme for marine surveyors since 2010.

Her Majesty's Government has no plans to fund CHIRP for maritime. CHIRP's activities to promote maritime safety have continued since 2011, now funded by maritime sector sponsors. This is a welcome arrangement, which illustrates the commitment of maritime organisations to support safe operations for the benefit of all mariners.

The Department commissioned the independently-led Review of Choice in End of Life Care which provided advice to Ministers last year. The Review set out a vision for enabling greater choice and improving quality at the end of life for every dying person.

We want to ensure that patients have greater choice about the care they receive at the end of their life and we are working with NHS England to see how this can best be achieved. We will set out our full response to the Choice Review shortly.

This data is not collected centrally.

The additional places will include placements in line with existing degrees, to do so there will be no change required to existing statutory regulation or education standards.Delivering suitable high quality placements as now, is part of the universities commitment on delivering an additional 10,000 student places.

Education standards will continue to be set United Kingdom-wide by the statutory Nursing and Midwifery Council and Health Care Professionals Council who as part of their approvals process assess the quality of practice placements. Professional bodies are also involved in setting curricula, particularly in the allied health professions and this will continue. It will be for universities to work as part of their local health economy with placement providers to secure extra placements for the additional students.

The Department did not hold any formal discussions or consultations with the highlighted stakeholders prior to the Spending Review announcement.

The Government received and considered a broad range of representations from a number of stakeholders during the Spending Review process.

Following the Spending Review the Department is absolutely commited to working with key stakeholders in implementing these reforms.

The Department of Health (DH) received joint correspondence from the Council of Deans of Health and Universities UK about a number of issues relating to healthcare education funding in England.

The Council of Deans of Health and Universities UK also wrote a joint letter to DH and the Department of Business, Innovation and Skills (BIS) Ministers on 7 August 2015 requesting a meeting to discuss a redesigned system. DH and BIS Ministers agreed to a joint meeting, which took place on the 2 December.

The following table shows the number of pre-registration nursing and midwifery places (degree and diploma courses) that were commissioned by year, for the period 2000-01 to 2015-16. Information on planned commissions for the period 1999-2000 is not available.

Source: multi professional education and training budget monitoring returns

Health Education England are the in process of developing commissioning plans for 2016-17. This process will conclude later this month with the publication of the Workforce Plan for England 2016-17.

The Department has no plans to move to the system proposed. Under the current system student nurses are supernumerary in the workforce during their clinical placements. This was introduced in the 1990s following criticisms, led by the Royal College of Nursing, that the employment model used student nurses as a major part of the workforce which did not effectively contribute to their learning, education and development to become competent registered nurses.

Neither the Department nor NHS England have made an assessment of the number of lives that might be saved per annum from licensing bisphosphonates for the treatment of early post-menopausal breast cancer.

Doctors can already prescribe a drug outside its licensed indications where they judge it to be the most clinically appropriate treatment for an individual patient.

Neither the Department nor NHS England have made an assessment of the number of lives that might be saved per annum from licensing bisphosphonates for the treatment of early post-menopausal breast cancer.

Doctors can already prescribe a drug outside its licensed indications where they judge it to be the most clinically appropriate treatment for an individual patient.

The net ingredient cost of prescription items dispensed in the community in England for bisphosphonates¹ in 2014, was £16.813 million².

In secondary care, the cost in 2014 was £35.841 million³.

The National Institute for Health and Care Excellence (NICE) has published clinical guidelines on early and locally advanced breast cancer and advanced breast cancer, published in February 2009, and familial breast cancer published in June 2013. NICE periodically reviews its guidance to take account of new and emerging evidence.

A copy of these clinical guidelines are attached.

¹ Bisphosphonates are defined as those included in paragraph 6.6.2 (Bisphosphonates and other drugs affecting bone metabolism) of the British National Formulary (BNF) but excluding denosumab and strontium ranelate.

² Source: Prescription Cost Analysis (PCA) provided by the Health and Social Care Information Centre

³ Source: Hospital Pharmacy Audit Index (HPAI) provided by IMS Health

Since 1 April 2013, NHS England has been responsible for commissioning augmentative and alternative communication (AAC) aids for patients with complex disability, such as motor neurone disease. Prior to this, there was no national AAC service which resulted in variation in provision of specialised AAC services and inequitable access for patients.

As the commissioner of specialised AAC services, NHS England is committed to improving access to the specialist assessments and equipment. Over the past two years it has worked hard to assess the levels of specialised AAC provision and levels of need and agree contracts with providers to deliver the new, national service. NHS England has allocated a £15 million recurring budget for the commissioning of AAC services for 2015/16 which builds on a part year allocation provided in 2014/15. All 13 AAC providers are accepting referrals and assessments are being offered to patients. Priority is being given to patients who have a life limiting condition and providers are working to ensure patients have timely access to assessment and services.

In my oral answer to the Noble Lord Hunt of Kings Heath on 13 July 2015, Official Report, column 345, I said that “the Government are committed to supporting NHS trusts to put in place sustained safe staffing by using their resources as effectively as possible for patients. The existing National Institute for Health and Care Excellence guidance on maternity settings and acute in-patient wards will continue to be used by NHS trusts. NHS England, working with NICE and other national organisations, will continue with this work in other areas of care and other healthcare professional groups”.

Subsequently, the Secretary of State announced that the responsibility for safe staffing will be taken forward by Dr Mike Durkin as part of the decision to transfer the national functions for safety to NHS Improvement. Dr Durkin will work with the Chief Nursing Officer to complete the work started by NICE on safe staffing levels. This work will be reviewed independently by NICE, the Chief Inspector of hospitals, and Sir Robert Francis to ensure it meets the high standards of care the NHS aspires to.

Future plans for safe staffing work will be developed in due course.

Ministers and officials in the Department hold regular discussions with colleagues from Monitor, NHS England and NICE on a range of issues including safe staffing. We have no plans to publish details of these meetings or correspondence between these organisations on this issue.

In my oral answer to the Noble Lord Hunt of Kings Heath on 13 July 2015, Official Report, column 345, I said that “the Government are committed to supporting NHS trusts to put in place sustained safe staffing by using their resources as effectively as possible for patients. The existing National Institute for Health and Care Excellence guidance on maternity settings and acute in-patient wards will continue to be used by NHS trusts. NHS England, working with NICE and other national organisations, will continue with this work in other areas of care and other healthcare professional groups”.

Subsequently, the Secretary of State announced that the responsibility for safe staffing will be taken forward by Dr Mike Durkin as part of the decision to transfer the national functions for safety to NHS Improvement. Dr Durkin will work with the Chief Nursing Officer to complete the work started by NICE on safe staffing levels. This work will be reviewed independently by NICE, the Chief Inspector of hospitals, and Sir Robert Francis to ensure it meets the high standards of care the NHS aspires to.

Future plans for safe staffing work will be developed in due course.

Ministers and officials in the Department hold regular discussions with colleagues from Monitor, NHS England and NICE on a range of issues including safe staffing. We have no plans to publish details of these meetings or correspondence between these organisations on this issue.

We welcome local innovations such as the role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust, but we have not made a formal assessment.

We do not have plans to roll out this position nationally. Local National Health Service organisations are responding to the challenges of the Francis Inquiry in a number of different ways, and we will continue to support them through mechanisms such as the patient safety collaboratives, and the work of organisations such as Health Education England and NHS England.

We welcome local innovations such as the role of the Ambassador for Cultural Change at the Staffordshire and Stoke-on-Trent Partnership NHS Trust, but we have not made a formal assessment.

We do not have plans to roll out this position nationally. Local National Health Service organisations are responding to the challenges of the Francis Inquiry in a number of different ways, and we will continue to support them through mechanisms such as the patient safety collaboratives, and the work of organisations such as Health Education England and NHS England.

The Whitley Council allowance for “nursing patients with infectious communicable diseases” ended when Agenda for Change (AfC) started in December 2004.

This is because AfC pay bands are related to the National Health Service job evaluation scheme. AfC was designed to ensure equal pay for staff carrying out work rated as ‘equivalent’ or ‘of equal value’. Factors which determined the need for Whitley allowances are measured in AfC by job evaluation. This determines the pay band which feeds through to pay.

Decisions relating to the banding of NHS staff, including nurses and midwives, are matters for the NHS organisation concerned as the employer. They are best placed to determine the content of individual jobs.