Written questions and answers

Written questions allow Members of Parliament to ask government ministers for information on the work, policy and activities of government departments.

Historical written answers can be found in Hansard.

Find the latest written questions and answers for the 2016-17 session below. We welcome your feedback on this service.

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Unique Identifying Number – Every written question in the House of Commons has a UIN per Parliament. In the House of Lords each written questions has a UIN per parliamentary session.
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Q
Asked by Lord Shinkwin
Asked on: 29 November 2016
Department of Health
Abortion
Lords
To ask Her Majesty’s Government what assessment they have made of the impact of section (1)(1)(d) of the Abortion Act 1967 on the mental health and wellbeing of people living with a disability.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

No such assessment has been made.

Q
Asked by Lord Shinkwin
Asked on: 30 November 2016
Department of Health
Down's Syndrome
Lords
To ask Her Majesty’s Government what is their response to the Royal College of Obstetricians and Gynaecologists' submission to the UK National Screening Committee concerning the case for making a rigorous analysis of the lifetime costs of caring for children and adults with Down's Syndrome.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

The cost analysis considered by the UK National Screening Committee (UK NSC) related solely to providing choice and did not take into account the lifetime costs of caring for children and adults with Down’s syndrome.

Thirty stakeholders responded to the UK NSC’s consultation, including the Royal College of Obstetricians and Gynaecologists. The UK NSC considered carefully all the responses to the consultation. However, as is standard practice there are no plans to respond to individual representations.

Q
Asked by Lord Shinkwin
Asked on: 30 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 22 November (HL3127), how the UK National Screening Committee, in making its recommendation on 15 January that non-invasive prenatal testing be approved, formally considered the write up from the roundtable discussion held by the Nuffield Council on Bioethics on 18 January.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

At its 19 November 2015 meeting, the UK National Screening Committee (UK NSC) recommended that non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes should be introduced as an additional test into the NHS Fetal Anomaly Screening Programme as part of an evaluation. The UK NSC held a three month public consultation on the GOV.UK website before making its recommendation. At its meeting in November 2015, the UK NSC reviewed all the responses to the consultation, including the ethical concerns raised before making its recommendation.

The Nuffield Council on Bioethics (NCOB) subsequently convened a roundtable in January 2016 to discuss clinical, ethical, social, legal and policy issues raised by recent developments in wider non-invasive prenatal diagnosis, testing and screening. The meeting was attended by 31 people, including healthcare professionals, academic researchers, policy makers, representatives of charities and patient groups, as well as members and officers of the UK NSC, including its ethicist.

Following the roundtable, the NCOB set up a working group in March 2016 to consider the ethical issues that would be raised by introducing NIPT into the National Health Service antenatal screening programme.

The UK NSC formally considered the NCOB’s write up of the roundtable at its meeting on 15 June 2016. In accordance with its terms of reference and as part of the ongoing evaluation the UK NSC will consider any significant new peer reviewed evidence, so will consider the report from the NCOB alongside any other new evidence when it becomes available.

Q
Asked by Lord Shinkwin
Asked on: 30 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government when they expect the assessment by the Nuffield Centre for Bioethics of the ethical implications of the introduction of the new non-invasive prenatal test to be completed.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

The Nuffield Council on Bioethics plans to publish the findings of its project on non-invasive prenatal testing in March 2017.

Q
Asked by Lord Shinkwin
Asked on: 30 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government whether the NHS is being, or will be, charged for the use of non-invasive prenatal testing technology by technology providers; and if so, what is their estimate of the annual cost to the NHS of such charges.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

Public Health England (PHE) is working through the procurement and the evaluative roll out process for non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes. It is estimated that the test will cost £200-300 per test and PHE has estimated that approximately 10,000 tests will take place per year. The overall cost is expected to be cost-neutral with less invasive procedures being undertaken.

Q
Asked by Lord Shinkwin
Asked on: 30 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 22 November (HL3127), and in the light of the failure by the Secretary of State for Health to respond to the request by Lord Shinkwin of 8 March 2016 to meet with him, people with Down’s Syndrome and their representatives to discuss their concerns about the impact of the new non-invasive pregnancy test on abortion rates of unborn babies diagnosed with Down’s Syndrome, what is their response to that request.
A
Answered by: Lord Prior of Brampton
Answered on: 12 December 2016

Ministers plan to meet stakeholders in the coming months to discuss concerns about the introduction of new technologies such as non-invasive prenatal testing which have the potential to increase the safety of screening tests.

Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government, in the light of the position of Jane Fisher as both a member of the National Screening Committee (NSC) and Director of Antenatal Results and Choices which receives funding from five biotech companies which develop non-invasive prenatal tests, what consideration they gave to the possibility of a conflict of interest having affected the NSC’s recommendation that non-invasive prenatal tests be offered on the NHS, prior to the decision to adopt that recommendation.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

Ms Jane Fisher is one of the patient and public voice representatives on the UK National Screening Committee (UK NSC). Members are appointed on to the UK NSC as individuals to fulfil the terms of reference of the committee, not as representatives of their particular professions, or their employer or any interest group. At the UK NSC’s meeting on 19 November 2015, Ms Fisher disclosed publicly that, “ARC has received unrestricted donations from biotechnical companies that provide non-invasive prenatal testing (NIPT) and a breakdown of donation has been provided to the UK NSC. ARC is a non-directive organisation which advocates individual choice. They do not promote any products or services. Money donated is put towards sustaining the service provided.” A copy of the minutes of the UK NSC’s meeting on 19 November 2015 is attached.

UK NSC minutes (PDF Document, 552.03 KB)
Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government whether ministers have met (1) Premaitha Health, or (2) any other biotech firm which develops non-invasive prenatal tests, in the last 12 months; and if so, which ministers were involved in those meetings, when they happened and where they were held.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

No Ministers at the Department have met with Premaitha Health. Ministers have regular meetings with biotech firms to discuss a variety of issues.

Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government, further to the Written Answer by Lord Prior of Brampton on 23 March (HL 7087), why, prior to the decision to introduce non-invasive prenatal testing (NIPT), they did not (1) meet people with Down’s syndrome and their families to discuss their concerns, (2) conduct an assessment of the impact of the introduction of NIPT on people with Down’s syndrome and their families and communities, (3) conclude an ethical review of NIPT, and (4) meet obligations arising under the Equality Act 2010.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

The UK National Screening Committee (UK NSC) has recommended that non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes should be introduced as an additional test into the NHS Fetal Anomaly Screening Programme as part of an evaluation. NIPT presents a more accurate and safer screen for Down’s syndrome and reduces the need for diagnostic invasive prenatal testing, which carries a risk of miscarriage. Modelling suggests that NIPT, as an additional test in the current screening pathway will result in the number of women offered invasive prenatal diagnosis (IPD) tests reducing from 7,910 to 1,434, leading to a reduction in IPD-related miscarriage of pregnancies from 46 to 3 per year. The new test will be offered to pregnant women whose chance of having a baby with Down’s, Edwards’ or Patau’s syndromes is greater than 1 in 150.

As is standard UK NSC procedure, a three month public consultation was held on the UK NSC’s review of NIPT for Down’s, Edwards’ and Patau’s syndromes. 30 stakeholders responded to the consultation, including organisations representing the interests of people with Down’s syndrome and their families and the Royal College of Obstetricians and Gynaecologists. The core aim of the NHS Fetal Anomaly Screening Programme is to provide information and choice. The cost analysis considered by the UK NSC related solely to providing choice and did not take into account the lifetime costs of caring for children and adults with Down’s syndrome.

In forming its advice, the UK NSC did give consideration to its ethical implications, in addition to the ethical issues raised in consultation, and formally considered the write up of the roundtable discussion, which was held by the Nuffield Council on Bioethics in January 2016. The roundtable discussions examined the ethical issues relating to the use of NIPT; a note of the meeting held on 18 January 2016 is attached. The UK NSC also sought expert input from its members in obstetrics, midwifery, paediatrics, genetics, patient and public voice alongside advice from the Department and was satisfied that the NHS Fetal Anomaly Screening Programme is compliant with obligations under the UN Convention on the Rights of Persons with Disabilities and that the Programme is compliant with any obligations under the Equality Act.

Nuffield Council on Bioethics minutes (PDF Document, 184.18 KB)
Grouped Questions: HL3129
Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Down's Syndrome: Screening
Lords
To ask Her Majesty’s Government why the Secretary of State for Health has not responded to (1) the letter of 8 March requesting a meeting with Lord Shinkwin and people with Down’s syndrome and their representatives to discuss concerns about the introduction of non-invasive prenatal testing (NIPT), and (2) the letter of 11 October, signed by over 900 people with Down’s syndrome and their families, detailing their concerns regarding the implementation of NIPT into the foetal anomaly screening programme.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

The response to the noble Lord’s letter of 8 March resulted in a meeting with the former Parliamentary Under Secretary of State for Public Health (Jane Ellison) and the noble Lord on 14 June to discuss non-invasive prenatal testing for Down’s, Edwards’ and Patau’s syndromes. A response to the Don’t Screen Us Out campaign’s letter of 11 October was sent to the campaign group on 11 November 2016.

Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Down's Syndrome: Screening
Lords
To ask Her Majesty’s Government what is their assessment of the submission by the Royal College of Obstetricians and Gynaecologists to the National Screening Committee concerning the case for a rigorous economic analysis to be made of the lifetime costs of caring for children and adults with Down’s syndrome.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

The UK National Screening Committee (UK NSC) has recommended that non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes should be introduced as an additional test into the NHS Fetal Anomaly Screening Programme as part of an evaluation. NIPT presents a more accurate and safer screen for Down’s syndrome and reduces the need for diagnostic invasive prenatal testing, which carries a risk of miscarriage. Modelling suggests that NIPT, as an additional test in the current screening pathway will result in the number of women offered invasive prenatal diagnosis (IPD) tests reducing from 7,910 to 1,434, leading to a reduction in IPD-related miscarriage of pregnancies from 46 to 3 per year. The new test will be offered to pregnant women whose chance of having a baby with Down’s, Edwards’ or Patau’s syndromes is greater than 1 in 150.

As is standard UK NSC procedure, a three month public consultation was held on the UK NSC’s review of NIPT for Down’s, Edwards’ and Patau’s syndromes. 30 stakeholders responded to the consultation, including organisations representing the interests of people with Down’s syndrome and their families and the Royal College of Obstetricians and Gynaecologists. The core aim of the NHS Fetal Anomaly Screening Programme is to provide information and choice. The cost analysis considered by the UK NSC related solely to providing choice and did not take into account the lifetime costs of caring for children and adults with Down’s syndrome.

In forming its advice, the UK NSC did give consideration to its ethical implications, in addition to the ethical issues raised in consultation, and formally considered the write up of the roundtable discussion, which was held by the Nuffield Council on Bioethics in January 2016. The roundtable discussions examined the ethical issues relating to the use of NIPT; a note of the meeting held on 18 January 2016 is attached. The UK NSC also sought expert input from its members in obstetrics, midwifery, paediatrics, genetics, patient and public voice alongside advice from the Department and was satisfied that the NHS Fetal Anomaly Screening Programme is compliant with obligations under the UN Convention on the Rights of Persons with Disabilities and that the Programme is compliant with any obligations under the Equality Act.

Nuffield Council on Bioethics minutes (PDF Document, 184.18 KB)
Grouped Questions: HL3127
Q
Asked by Lord Shinkwin
Asked on: 08 November 2016
Department of Health
Abortion
Lords
To ask Her Majesty’s Government whether they are taking action to reduce the number of late term abortions for reasons of disability; and if so, what.
A
Answered by: Lord Prior of Brampton
Answered on: 22 November 2016

Guidance from the Royal College of Obstetricians and GynaecologistsThe Care of Women Requesting Induced Abortion (Evidence-based Clinical Guideline Number 7) already makes it clear that women and their partners should receive appropriate information and support from a properly trained multidisciplinary team, who must adopt a non-judgemental approach regardless of the woman’s decision. This should include referral to other professional experts (including palliative care) and referral for counselling when this can help, as part of a co-ordinated package of care. A copy of the guidance is attached.

Care of women clinical guideline (PDF Document, 792.89 KB)
Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Antenatal Results and Choices: Finance
Lords
To ask Her Majesty’s Government what was the total amount of public money given to Antenatal Results and Choices (ARC) or its precursor organisation, Support After Termination for Abnormality, in each of the last 10 years; and for what purposes the money was given.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

The Department has made a number of payments to Antenatal Results and Choices over a period spanning from 2009-10 to 2012-13. The Department’s financial systems only allow full financial year reporting of expenditure from 2009-10 onwards.

The payments made by financial year are as follows:

Financial Year

Payment

Purpose

2009-10

£145.25

Reimbursement for meeting attendance

2010-11

£15,000.00

Grant to improve Black and Minority Ethnic (BME) antenatal support

2011-12

£5,000.00

Grant to improve BME antenatal support

2012-13

£14,000.00

Grant to improve care following a first trimester pre-natal diagnosis

2012-13

£5,450.00

Grant to improve care following a first trimester pre-natal diagnosis

Total

£39,585.25

Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government which groups the Department of Health met before making the decision to introduce non-invasive prenatal testing on the NHS.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

The Department takes advice on all aspects of screening from the independent UK National Screening Committee (UK NSC) and has met with its Secretariat to discuss its recommendation on non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes as an additional test in the current NHS Fetal Anomaly Screening Programme.

NIPT presents a more accurate and safer screen for Down’s syndrome and reduces the need for diagnostic invasive prenatal testing, which carries a risk of miscarriage. Modelling suggests that NIPT, as an additional test in the current screening pathway will result in the number of women offered invasive prenatal diagnosis (IPD) tests reducing from 7,910 to 1,434, leading to a reduction in IPD-related miscarriage of pregnancies from 46 to 3 per year. The new test will be offered to pregnant women whose chance of having a baby with Down’s, Edwards’ or Patau’s syndromes is greater than 1 in 150.

As is standard practice, the UK NSC held a three month public consultation to enable stakeholders to feed into the review. 30 responses were received to the consultation from a wide range of stakeholders. A copy of the responses to the consultation is attached.

The Department is satisfied that the screening programme is compliant with its obligations under the United Nations Convention on the Rights of Persons with Disabilities and that the Programme is compliant with any obligations under the Equality Act.

Consultation Responses (PDF Document, 1.39 MB)
Grouped Questions: HL3063
Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Pregnancy: Screening
Lords
To ask Her Majesty’s Government whether an equality impact assessment was conducted before the decision was made to introduce non-invasive prenatal testing on the NHS.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

The Department takes advice on all aspects of screening from the independent UK National Screening Committee (UK NSC) and has met with its Secretariat to discuss its recommendation on non-invasive prenatal testing (NIPT) for Down’s, Edwards’ and Patau’s syndromes as an additional test in the current NHS Fetal Anomaly Screening Programme.

NIPT presents a more accurate and safer screen for Down’s syndrome and reduces the need for diagnostic invasive prenatal testing, which carries a risk of miscarriage. Modelling suggests that NIPT, as an additional test in the current screening pathway will result in the number of women offered invasive prenatal diagnosis (IPD) tests reducing from 7,910 to 1,434, leading to a reduction in IPD-related miscarriage of pregnancies from 46 to 3 per year. The new test will be offered to pregnant women whose chance of having a baby with Down’s, Edwards’ or Patau’s syndromes is greater than 1 in 150.

As is standard practice, the UK NSC held a three month public consultation to enable stakeholders to feed into the review. 30 responses were received to the consultation from a wide range of stakeholders. A copy of the responses to the consultation is attached.

The Department is satisfied that the screening programme is compliant with its obligations under the United Nations Convention on the Rights of Persons with Disabilities and that the Programme is compliant with any obligations under the Equality Act.

Consultation Responses (PDF Document, 1.39 MB)
Grouped Questions: HL3062
Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Abortion
Lords
To ask Her Majesty’s Government what was the percentage increase in the number of abortions performed on the grounds of disability between 1986 and 2015.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

There was a 64% increase in the number of abortions performed under Ground E (fetal abnormality) between 1986 (1,963) and 2015 (3,213).

The number of abortions performed under Ground E after 24 weeks gestation increased from 58 to 177 between 1991 and 2015, a 205% increase. This data should be seen in the context of the overall number of conceptions each year, of which there were 829,690 in England in 2014 (the latest year for which data are available).

The number of abortions for Down's syndrome was not recorded in 1991 as there was no diagnosis code specific to Down’s Syndrome in the International Classification of Diseases, therefore a comparison between 1991 and 2015 levels is not available. There are complex reasons why there has been an increase in abortion for fetal abnormality which reflect societal changes. The age at which women are giving birth is increasing and age is a known risk for some anomalies. Increasing levels of obesity may also be a factor. Screening techniques have also improved which means that anomalies can be more accurately detected.

Grouped Questions: HL3065 | HL3066
Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Abortion
Lords
To ask Her Majesty’s Government what was the percentage increase in the number of late term abortions (after 24 weeks) performed on the grounds of disability between 1991 and 2015.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

There was a 64% increase in the number of abortions performed under Ground E (fetal abnormality) between 1986 (1,963) and 2015 (3,213).

The number of abortions performed under Ground E after 24 weeks gestation increased from 58 to 177 between 1991 and 2015, a 205% increase. This data should be seen in the context of the overall number of conceptions each year, of which there were 829,690 in England in 2014 (the latest year for which data are available).

The number of abortions for Down's syndrome was not recorded in 1991 as there was no diagnosis code specific to Down’s Syndrome in the International Classification of Diseases, therefore a comparison between 1991 and 2015 levels is not available. There are complex reasons why there has been an increase in abortion for fetal abnormality which reflect societal changes. The age at which women are giving birth is increasing and age is a known risk for some anomalies. Increasing levels of obesity may also be a factor. Screening techniques have also improved which means that anomalies can be more accurately detected.

Grouped Questions: HL3064 | HL3066
Q
Asked by Lord Shinkwin
Asked on: 07 November 2016
Department of Health
Abortion
Lords
To ask Her Majesty’s Government what was the percentage increase in the number of abortions for Down's syndrome between 1991 and 2015.
A
Answered by: Lord Prior of Brampton
Answered on: 21 November 2016

There was a 64% increase in the number of abortions performed under Ground E (fetal abnormality) between 1986 (1,963) and 2015 (3,213).

The number of abortions performed under Ground E after 24 weeks gestation increased from 58 to 177 between 1991 and 2015, a 205% increase. This data should be seen in the context of the overall number of conceptions each year, of which there were 829,690 in England in 2014 (the latest year for which data are available).

The number of abortions for Down's syndrome was not recorded in 1991 as there was no diagnosis code specific to Down’s Syndrome in the International Classification of Diseases, therefore a comparison between 1991 and 2015 levels is not available. There are complex reasons why there has been an increase in abortion for fetal abnormality which reflect societal changes. The age at which women are giving birth is increasing and age is a known risk for some anomalies. Increasing levels of obesity may also be a factor. Screening techniques have also improved which means that anomalies can be more accurately detected.

Grouped Questions: HL3064 | HL3065
Q
Asked by Lord Shinkwin
Asked on: 29 June 2016
HM Treasury
Gift Aid
Lords
To ask Her Majesty’s Government on how many occasions (1) in the last tax year for which figures are available, and (2) for each of the tax years since the introduction of Gift Aid, HMRC reclaimed or recovered Gift Aid from an individual because they had mistakenly made a Gift Aid declaration to a charity or had not paid sufficient tax to cover the Gift Aid.
A
Answered by: Lord O'Neill of Gatley
Answered on: 12 July 2016

Around £1.3bn of Gift Aid was paid to charities in 2015/16, the highest year of Gift Aid payments since the scheme began. During 2015/16, HMRC contacted 2,580 individuals where a shortfall was identified in the tax needed to cover the donation. Individual donors are responsible for ensuring they have paid sufficient tax to cover any Gift Aid reclaimed in their donation. No statistics are available for earlier years.

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