In 2013-14 we estimate that the UK Government spend on malaria control was £536 million. This has been calculated using the methodology detailed in the Malaria Framework of Results. This can be found at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/67642/malaria-framework-for-results.pdf.

Malaria death rates have been falling globally since 2010 and the UK investments have significantly contributed to this achievement. According to analysis of current trends by the World Health Organization, by 2015, six high burden countries are on track to halve malaria mortality from a 2009 baseline and another six high burden countries are on track to achieve a 40-50% reduction in malaria attributable deaths. More detail on the UK’s achievements can be found at https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/410980/DFID_Mid-Year_Report_Achievements_Annex.pdf.

A smear test is primarily used for screening purposes, and is unlikely to be appropriate when a woman has gynaecological issues that are symptomatic of cancer.

In such cases the National Institute for Health and Care Excellence Referral Guidelines for Suspected Cancer (2005) are available to help general practitioners (GPs) assess when it is appropriate to refer patients for suspected cancer, including cervical cancer. The Guidelines make clear recommendations in relation to gynaecological cancer, and state that:

“A patient who presents with symptoms suggesting gynaecological cancer should be referred to a team specialising in the management of gynaecological cancer, depending on local arrangements.”

In relation to cervical cancer the guidelines make clear that a smear test is not required before referral:

“In patients found on examination to have clinical features that raise the suspicion of cervical cancer, an urgent referral should be made. A cervical smear test is not required before referral, and a previous negative cancer smear result is not a reason to delay referral.”

Therefore, when a woman is experiencing gynaecological problems which are symptomatic of gynaecological cancer, their GP would be expected to refer them to the appropriate specialist without needing to conduct a smear test.

A cervical screening test is a population screening test, not a diagnostic test, and is therefore not appropriate for women with symptoms. Waiting two weeks for a smear test result could delay examination by a gynaecologist. The Department has published guidance for general practitioners (GPs) on managing young women aged 20-24 with abnormal vaginal bleeding. This is available at:

http://www.cancerscreening.nhs.uk/cervical/publications/doh-guidelines-young-women.pdf

Information for women of all ages on the symptoms of cervical cancer is available on the NHS Choices website at:

http://www.nhs.uk/conditions/cancer-of-the-cervix/pages/introduction.aspx

The Department advises women who are concerned about cervical cancer to speak to their GP.

In England, Pharmaceutical Price Regulation Scheme (PPRS) payments are taken into account in the allocations to NHS England through the Mandate. All the payments will go back into spending on improving patients’ health and care.

The NHS England budget for 2015-16 already takes account for money anticipated from higher than expected PPRS payments. The Mandate for 2015-16 has a set firm NHS England budget for 2015-16, which is £3billion (3%) higher than its budget for 2014-15. This increase takes into account a number of things, including additional funding for the National Health Service announced in the Autumn Statement and the fact that the PPRS payment in 2015-16 is now forecast to be higher than originally expected.

It will be up to NHS England how they split that overall budget between clinical commissioning groups, specialised commissioning etc. Following normal Government accounting rules there is no separately identified ring-fenced funding stream associated with the PPRS payment.

The PPRS helps all member companies to compete globally by providing stability in United Kingdom prices. It includes a number of initiatives to help speed uptake of medicines approved by National Institute for Health and Care Excellence in the NHS. Sales of new active substances launched on or after 1 January 2014 are exempt from payments though still included in the overall limit on growth and the payments made by industry as a whole. This recognises and rewards innovation.

Net sales growth from the first nine months of 2014 compared to 2013 was 5.9 per cent. This was higher than the agreed forecast growth of 3.87 per cent. and shows that patients are benefitting from greater access to branded medicines. Most companies have enjoyed growth in sales in 2014, with over 40 per cent. of companies having double-digit growth rates.

In England, Pharmaceutical Price Regulation Scheme (PPRS) payments are taken into account in the allocations to NHS England through the Mandate. All the payments will go back into spending on improving patients’ health and care.

The NHS England budget for 2015-16 already takes account for money anticipated from higher than expected PPRS payments. The Mandate for 2015-16 has a set firm NHS England budget for 2015-16, which is £3billion (3%) higher than its budget for 2014-15. This increase takes into account a number of things, including additional funding for the National Health Service announced in the Autumn Statement and the fact that the PPRS payment in 2015-16 is now forecast to be higher than originally expected.

It will be up to NHS England how they split that overall budget between clinical commissioning groups, specialised commissioning etc. Following normal Government accounting rules there is no separately identified ring-fenced funding stream associated with the PPRS payment.

The PPRS helps all member companies to compete globally by providing stability in United Kingdom prices. It includes a number of initiatives to help speed uptake of medicines approved by National Institute for Health and Care Excellence in the NHS. Sales of new active substances launched on or after 1 January 2014 are exempt from payments though still included in the overall limit on growth and the payments made by industry as a whole. This recognises and rewards innovation.

Net sales growth from the first nine months of 2014 compared to 2013 was 5.9 per cent. This was higher than the agreed forecast growth of 3.87 per cent. and shows that patients are benefitting from greater access to branded medicines. Most companies have enjoyed growth in sales in 2014, with over 40 per cent. of companies having double-digit growth rates.

Public Health England supports work on local prioritisation of hepatitis C services by producing factsheets for local government, publishing a template to support commissioning by estimating the number of people infected with hepatitis C locally and the costs of treatment. It has also published local liver profiles at local authority level which includes, key local statistics and prevention guidance on hepatitis C and questions for local authority Health and Wellbeing Boards to consider.

There are currently no national direct financial incentives for screening programmes to improve the diagnostic rates for hepatitis C. However, NHS England sub-regions, working with other commissioners, have the ability to implement local incentives to improve diagnosis. The Department does not hold any information about any such local incentives that might have been put in place, including Cheshire.

My right hon. Friend makes an important point. It is good news that, in the north-west, we have seen the claimant count in his constituency come down by 40% in the past year. If we want to sustain the increase in employment and sustain our economic growth, however, we should not hold ourselves back from new sources of energy, including unconventional gas. It is striking that the United States has something like 100,000 unconventional gas wells, whereas there are only about 100 in the whole of Europe. We have about three quarters as much unconventional gas across the

EU as there is in America, and I do not want us to miss out on this. It could help to deliver more competitive energy prices, it will help to keep our economy and our industry competitive, and I think it is vital for the future of our country.

I refer the right hon. Member to the answer that I gave him on 8 July 2014, Official Report, column 237W.

In order to estimate the cost of a homicide, the Home Office uses the value of a prevented fatality, which is estimated by the Department for Transport. The Home Office has produced three reports on the economic and social costs of crime, which contain the Department’s estimates of the value of preventing a fatality in relation to a homicide. The Home Office first estimated the economic and social costs of crime in 2000:

http://webarchive.nationalarchives.gov.uk/20110218135832/rds.homeoffice.gov.uk/rds/pdfs/hors217.pdf

The Home Office last comprehensively updated the costs of crime estimates in 2005:

http://webarchive.nationalarchives.gov.uk/20100413151441/http:/www.homeoffice.gov.uk/rds/pdfs05/rdsolr3005.pdf

The Home Office’s 2011 publication provides its most recent revision to the unit costs of crime figures:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/97813/IOM-phase2-costs-multipliers.pdf

The costs within the costs of crime report are used to inform policy development. For example, the rationale in the impact assessment for Domestic Violence Disclosure Scheme refers to the average and total cost of homicides related to domestic violence and abuse:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/260899/DVDS_IA.pdf

The National Institute for Health and Care Excellence (NICE) has advised that the next meeting of its highly specialised technology evaluation committee will take place on 24 July 2014. If the committee agrees final draft recommendations on eculizumab for the treatment of atypical haemolytic uraemic syndrome, NICE will aim to make them available in September in line with its interim process guide. NHS England's response will form part of the documentation published and a copy will be placed in the Library at this time.

When carrying out an appraisal my Department follows the principles set out in the HM Treasury’s Green Book: Appraisal and Evaluation in Central Government. The Green Book includes guidance

on how to value the prevention of fatalities and injuries. One of the approaches in the Green Book used by my Department is the Department for Transport’s valuation of a fatality. The latest monetary value is publicly available on their website.

An example of where this valuation has been applied is the recent changes to Part P Building Regulations covering electrical safety in dwellings. The impact assessment setting out the analysis is publicly available.

In order to estimate the cost of a homicide, the Home Office uses the value of a prevented fatality, which is estimated by the Department for Transport. The Home Office first estimated the social and economic costs of crime in 2000:

http://webarchive.nationalarchives.gov.uk/20110218135832/rds.homeoffice.gov.uk/rds/pdfs/hors217.pdf

The Home Office last comprehensively updated the costs of crime estimates in 2005:

http://webarchive.nationalarchives.gov.uk/20100413151441/http:/www.homeoffice.gov.uk/rds/pdfs05/rdsolr3005.pdf

The most recent update to the Home Office’s estimates of the costs of crime prior to the Department’s submission to the Inter-departmental Group for the Valuation of Life and Health review in 2008 was the 2005 publication. The monetary value per quality-adjusted life year used in the 2005 report was £80,620 in 2003 prices.

The most recent update to the Home Office’s estimates of the costs of crime prior to the Department’s submission to the Inter-departmental Group for the Valuation of Life and Health review in 2008 was the 2005 publication. The monetary value per quality-adjusted life year used in the 2005 report was £80,620 in 2003 prices.

I refer my hon. Friend to my answer of 7 July 2014, Official Report, column 167WJ.

The value of a prevented fatality is used in the appraisal for every infrastructure investment business case. It is also used in the impact assessments for relevant policy interventions. For example, the impact assessment on the new drug driving offence takes account of the value of preventing a fatality in assessing the overall impact of the offence. The latest impact assessment can be found at:

http://www.legislation.gov.uk/ukdsi/2014/9780111117422/impacts

The information requested has been placed in the Library.

I refer the right hon. Member to the reply given on 7 July 2014, Official Report, column 73W.

An example of a policy intervention where the reduction of risk of death is valued is in the consultation stage impact assessment on whether to issue a ministerial direction for the preparation of reservoir flood plans, issued on 17 December 2009. This document has been placed in the House Library.

The value of a prevented fatality is not normally used in the appraisal of policy or project proposals by the Department. The standard unit of impact for appraisal of projects and policies that have an impact upon mortality or morbidity, including prevention of fatalities, is a statistical life year (SLY), with adjustment for quality of life impacts where appropriate (in which case quality adjusted life years (QALYs) are used). SLYs and QALYs are valued at roughly £60,000. This valuation is consistent with the willingness of members of the public to pay for

improvement in health and risk outcomes elicited in the study that underpins the valuation of prevented fatalities by the Department for Transport and other Departments (Carthy T., Chilton S., Covey J., Hopkins L., Jones-Lee M., Loomes G., Pidgeon N., Spencer A., “The Contingent-Valuation of Safety and the Safety of Contingent Valuation, part 2: The CV/SG Chained Approach”, Journal of Risk and Uncertainty, 1999, 17: 187-213.)

This valuation of SLYs is used by the Department in its impact assessment of the proposed draft regulations for standardised packaging of tobacco products upon which the Department is currently consulting.

A copy of the impact assessment has been placed in the Library and is available at:

www.gov.uk/government/consultations/standardised-packaging-of-tobacco-products-draft-regulations