To ask Her Majesty’s Government whether appropriate treatment for patients with plasma disorders such as haemophilia and primary immunodeficiency, as provided for under the statutory scheme for branded medicines, will continue to be provided following the review of that scheme by the Department of Health.

To ask Her Majesty’s Government whether appropriate treatment for patients with plasma disorders such as haemophilia and primary immunodeficiency, as provided for under the statutory scheme for branded medicines, will continue to be provided following the review of that scheme by the Department of Health.

My Lords, is the Minister satisfied that the individuals chosen to assess the nature and significance of the disability of disabled individuals are properly qualified and trained to carry out such assessments, and that in doing so they employ well-defined and reproducible criteria?

My Lords, is the Minister satisfied that the individuals chosen to assess the nature and significance of the disability of disabled individuals are properly qualified and trained to carry out such assessments, and that in doing so they employ well-defined and reproducible criteria?

My Lords, the whiplash phenomenon is thought to occur usually when a vehicle is struck heavily from behind, with the result that the passenger or driver in the vehicle that is hit has a sharp flexion of the neck followed by a sharp hyperextension. If it happens that the individual in question already has disc degeneration in the neck, there is no doubt at all that this may on occasions result in actual damage to the spinal cord with significant physical results. However, in the great majority of so-called whiplash cases, no organic abnormality can be detected. Indeed, there is considerable evidence that some of the claims for whiplash injuries are spurious. Having said that, is it not time yet again for the Government and the medical profession experts in this field to come together to see if they can promulgate some objective means of assessing the significance of these claims?

My Lords, the whiplash phenomenon is thought to occur usually when a vehicle is struck heavily from behind, with the result that the passenger or driver in the vehicle that is hit has a sharp flexion of the neck followed by a sharp hyperextension. If it happens that the individual in question already has disc degeneration in the neck, there is no doubt at all that this may on occasions result in actual damage to the spinal cord with significant physical results. However, in the great majority of so-called whiplash cases, no organic abnormality can be detected. Indeed, there is considerable evidence that some of the claims for whiplash injuries are spurious. Having said that, is it not time yet again for the Government and the medical profession experts in this field to come together to see if they can promulgate some objective means of assessing the significance of these claims?

My Lords, I declare an interest as in 1950 I was elected chairman of the BMA’s Registrars Group, the predecessor of the present Junior Doctors Committee. I express the fervent hope that the current negotiations between the BMA and the Government will quickly be concluded to the satisfaction of both parties. In my view and in the view of many doctors it is a matter of considerable concern that there is a suggestion of further industrial action, which is inimical to the ethos of a caring profession. Will the Minister accept my view that the alleged threat by the Secretary of State to impose a new contract of employment on all junior doctors without agreement is outrageous?

My Lords, I declare an interest as in 1950 I was elected chairman of the BMA’s Registrars Group, the predecessor of the present Junior Doctors Committee. I express the fervent hope that the current negotiations between the BMA and the Government will quickly be concluded to the satisfaction of both parties. In my view and in the view of many doctors it is a matter of considerable concern that there is a suggestion of further industrial action, which is inimical to the ethos of a caring profession. Will the Minister accept my view that the alleged threat by the Secretary of State to impose a new contract of employment on all junior doctors without agreement is outrageous?

My Lords, is the Minister aware that regional airports in the United Kingdom such as Newcastle, which is expanding and becoming much busier, are expressing serious concern about the adverse effect on their activities of the lack of capacity in the south-east? Is the Minister absolutely confident that a new runway will be built, or is this beginning to look increasingly like a figment of the Government’s imagination?

My Lords, is the Minister aware that regional airports in the United Kingdom such as Newcastle, which is expanding and becoming much busier, are expressing serious concern about the adverse effect on their activities of the lack of capacity in the south-east? Is the Minister absolutely confident that a new runway will be built, or is this beginning to look increasingly like a figment of the Government’s imagination?

My Lords, my former medical colleagues in Newcastle upon Tyne, including several distinguished hepatologists are gravely concerned by the increasing incidence of alcohol- induced liver disease in young people. The problem is that in Newcastle—in the centre of the city and on the quayside—many organisations sell what are called, “cheap shots” with a very high alcohol content. Surely the time has come, yet again for the Government to give urgent consideration to the introduction of a statutory minimum price per unit of alcohol.

My Lords, my former medical colleagues in Newcastle upon Tyne, including several distinguished hepatologists are gravely concerned by the increasing incidence of alcohol- induced liver disease in young people. The problem is that in Newcastle—in the centre of the city and on the quayside—many organisations sell what are called, “cheap shots” with a very high alcohol content. Surely the time has come, yet again for the Government to give urgent consideration to the introduction of a statutory minimum price per unit of alcohol.

My Lords, one of the great advantages of the pneumococcal vaccination programme is that it is widely believed that a single injection gives lifelong protection—or at least substantially lifelong protection—against pneumococcal pneumonia and pneumococcal meningitis. Is the Minister satisfied that that is still sufficient?

My Lords, one of the great advantages of the pneumococcal vaccination programme is that it is widely believed that a single injection gives lifelong protection—or at least substantially lifelong protection—against pneumococcal pneumonia and pneumococcal meningitis. Is the Minister satisfied that that is still sufficient?

My Lords, is the Minister aware that the poliomyelitis virus attacks the nerve cells in the brain stem and spinal cord which give origin to the nerves that control the movement of the muscles, and, hence, that if these cells are killed, the result is paralysis of the relevant muscles? Several authorities believe that in an acute attack of poliomyelitis, certain nerve cells are damaged but recover, only to die prematurely some years later, thus causing the post-polio syndrome of progressive muscular weakness. Would not one important strategy be to have a graded exercise programme to try to increase the power of those muscles that retain a viable nerve supply?

My Lords, is the Minister aware that the poliomyelitis virus attacks the nerve cells in the brain stem and spinal cord which give origin to the nerves that control the movement of the muscles, and, hence, that if these cells are killed, the result is paralysis of the relevant muscles? Several authorities believe that in an acute attack of poliomyelitis, certain nerve cells are damaged but recover, only to die prematurely some years later, thus causing the post-polio syndrome of progressive muscular weakness. Would not one important strategy be to have a graded exercise programme to try to increase the power of those muscles that retain a viable nerve supply?

My Lords, I am not the only doctor to have expressed some reservations when the Health and Social Care Act decided to transfer funding for public health from the National Health Service to the local authorities. Do the Government now regret that decision in the light of the problems highlighted in the Question—particularly at a time when public health is facing enormous challenges, not least due to the obesity epidemic and the alarming increase in the incidence of type 2 diabetes?

My Lords, I am not the only doctor to have expressed some reservations when the Health and Social Care Act decided to transfer funding for public health from the National Health Service to the local authorities. Do the Government now regret that decision in the light of the problems highlighted in the Question—particularly at a time when public health is facing enormous challenges, not least due to the obesity epidemic and the alarming increase in the incidence of type 2 diabetes?

My Lords, I declare an interest in that for many years I have been a member of the ALCS—the Authors’ Licensing and Collecting Society—from which I receive minuscule sums about twice a year when people, in their wisdom, decide either to borrow or to photocopy from any of my published works. Many libraries have lost their paid staff and are staffed wholly by volunteers. Can the Minister say whether such libraries are no longer covered by the public lending right so that those authors whose works are photocopied or borrowed from them no longer receive any financial benefit?

My Lords, I declare an interest in that for many years I have been a member of the ALCS—the Authors’ Licensing and Collecting Society—from which I receive minuscule sums about twice a year when people, in their wisdom, decide either to borrow or to photocopy from any of my published works. Many libraries have lost their paid staff and are staffed wholly by volunteers. Can the Minister say whether such libraries are no longer covered by the public lending right so that those authors whose works are photocopied or borrowed from them no longer receive any financial benefit?

Can the Minister say what qualifications are now required of doctors who are recruited to work in prisons? Can he further say what proportion of those who are now employed to work in prisons have had formal psychiatric training?

Can the Minister say what qualifications are now required of doctors who are recruited to work in prisons? Can he further say what proportion of those who are now employed to work in prisons have had formal psychiatric training?

Is the Minister aware that, in 2000, your Lordships’ Select Committee on Science and Technology, of which I was then a member, conducted a major investigation into the potential medical benefits of cannabis preparations and cannabis itself. We were satisfied that smoking cannabis was just as dangerous in causing cancer as smoking tobacco, if not more so. Nevertheless, we received substantial anecdotal evidence of benefits from cannabis ingestion in a variety of medical conditions. Subsequently, a company called GW Pharmaceuticals produced a wholly standardised cannabis-based preparation. That was subjected to some very convincing clinical trials which led to it being licensed by the MHRA in 2010 for the treatment of spasms and spasticity in multiple sclerosis. That is now the case, but the evidence is growing that various cannabinoids may also be of benefit. Would not the reschedule recommended by my noble friend Lady Meacher help to expedite additional trials and lead to the beneficial effects of cannabis being more available for medical conditions?

Is the Minister aware that, in 2000, your Lordships’ Select Committee on Science and Technology, of which I was then a member, conducted a major investigation into the potential medical benefits of cannabis preparations and cannabis itself. We were satisfied that smoking cannabis was just as dangerous in causing cancer as smoking tobacco, if not more so. Nevertheless, we received substantial anecdotal evidence of benefits from cannabis ingestion in a variety of medical conditions. Subsequently, a company called GW Pharmaceuticals produced a wholly standardised cannabis-based preparation. That was subjected to some very convincing clinical trials which led to it being licensed by the MHRA in 2010 for the treatment of spasms and spasticity in multiple sclerosis. That is now the case, but the evidence is growing that various cannabinoids may also be of benefit. Would not the reschedule recommended by my noble friend Lady Meacher help to expedite additional trials and lead to the beneficial effects of cannabis being more available for medical conditions?

Would the Minister accept that NICE is faced with an extremely difficult problem in continually having to consider the efficacy and affordability of new cancer drugs as they emerge in a National Health Service under financial constraint? Would he also accept that another major problem is emerging in relation to the orphan and ultra-orphan drugs now coming on stream for the treatment of rare diseases, which are equally deserving in many respects? How does he feel that the next Government—however they are constituted—will be able to consider this increasingly serious problem?

Would the Minister accept that NICE is faced with an extremely difficult problem in continually having to consider the efficacy and affordability of new cancer drugs as they emerge in a National Health Service under financial constraint? Would he also accept that another major problem is emerging in relation to the orphan and ultra-orphan drugs now coming on stream for the treatment of rare diseases, which are equally deserving in many respects? How does he feel that the next Government—however they are constituted—will be able to consider this increasingly serious problem?

My Lords, in light of the alarming increase in type 2 diabetes, which is closely related to the incidence of obesity, what advice are the Government giving to the population at large about the dangers of overeating? When I was in clinical practice I used to advise my overweight patients to take a large dose of will power three times a day with meals.

My Lords, in light of the alarming increase in type 2 diabetes, which is closely related to the incidence of obesity, what advice are the Government giving to the population at large about the dangers of overeating? When I was in clinical practice I used to advise my overweight patients to take a large dose of will power three times a day with meals.

To ask Her Majesty’s Government why the acute adult dermatology service at Nottingham University Hospital is to be closed; and whether they have assessed the effect that that decision will have upon patients in the area affected by skin diseases.

To ask Her Majesty’s Government why the acute adult dermatology service at Nottingham University Hospital is to be closed; and whether they have assessed the effect that that decision will have upon patients in the area affected by skin diseases.

To ask Her Majesty’s Government what effect they consider the loss of six consultant dermatologists in Nottingham will have upon direct services to the local community and the training of junior doctors and medical students.

To ask Her Majesty’s Government what effect they consider the loss of six consultant dermatologists in Nottingham will have upon direct services to the local community and the training of junior doctors and medical students.

My Lords, in the course of my career in neurology I have treated many patients with epilepsy at all ages and in all its variants. There is no doubt that there has been a remarkable transformation in the management of all the types of this condition as a result of research in our universities and in the pharmaceutical industry. Nevertheless, there are still some patients in whom seizures are intractable and do not respond effectively even to the most modern drugs. Quite apart from what the Neurological Alliance has said, is the Minister aware that the Association of British Neurologists has identified a striking unevenness in the quality and availability of specialised neurological care throughout the country? What are the Government doing to make certain that these facilities, which are so necessary in treating this condition, are more properly and evenly distributed?

My Lords, in the course of my career in neurology I have treated many patients with epilepsy at all ages and in all its variants. There is no doubt that there has been a remarkable transformation in the management of all the types of this condition as a result of research in our universities and in the pharmaceutical industry. Nevertheless, there are still some patients in whom seizures are intractable and do not respond effectively even to the most modern drugs. Quite apart from what the Neurological Alliance has said, is the Minister aware that the Association of British Neurologists has identified a striking unevenness in the quality and availability of specialised neurological care throughout the country? What are the Government doing to make certain that these facilities, which are so necessary in treating this condition, are more properly and evenly distributed?

My Lords, would the Minister accept that the Select Committee structure is one of the great strengths of this House? I served for many years on the Science and Technology Select Committee and had the privilege of chairing several sub-committee inquiries. One of those, relating to research in the NHS, led to the Culyer report, then to the establishment of the National Institute for Health Research and now has led on to the development of the massive Crick centre for research in the centre of London. Can the Minister give us any inkling as to the extent to which Select Committee reports in this House have led to major changes in government policy over the last few years?

My Lords, would the Minister accept that the Select Committee structure is one of the great strengths of this House? I served for many years on the Science and Technology Select Committee and had the privilege of chairing several sub-committee inquiries. One of those, relating to research in the NHS, led to the Culyer report, then to the establishment of the National Institute for Health Research and now has led on to the development of the massive Crick centre for research in the centre of London. Can the Minister give us any inkling as to the extent to which Select Committee reports in this House have led to major changes in government policy over the last few years?

To ask Her Majesty’s Government how they propose to respond to the survey of Acute Neurology Services issued by the Association of British Neurologists in December; and what action they plan to take to ensure that clearly defined quality standards in acute neurology are achieved evenly throughout the United Kingdom...

To ask Her Majesty’s Government how they propose to respond to the survey of Acute Neurology Services issued by the Association of British Neurologists in December; and what action they plan to take to ensure that clearly defined quality standards in acute neurology are achieved evenly throughout the United Kingdom...

To ask Her Majesty’s Government whether they will publish a report on the work of the Rare Diseases Advisory Group, indicating the extent to which its recommendations have influenced the decisions of the National Institute for Health and Care Excellence and NHS England.

To ask Her Majesty’s Government whether they will publish a report on the work of the Rare Diseases Advisory Group, indicating the extent to which its recommendations have influenced the decisions of the National Institute for Health and Care Excellence and NHS England.