Whooping Cough
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
On 4 March 2024, the UK Health Security Agency launched a new multimedia marketing campaign across England to remind parents and carers of the risk of their children missing out on protection against serious diseases that are re-emerging in the country, with an urgent call for action to catch up on missed vaccinations. NHS England is implementing best practice, vaccinating pregnant women opportunistically during maternity appointments wherever possible and ensuring that advice on vaccination in pregnancy is being offered across antenatal and primary care settings. I can reassure the noble Baroness, and indeed the House, that NHS England is doing all it can to contact pregnant women to make sure they are vaccinated themselves, which will help the unborn child.
Lord Patel (CB)
My Lords, the incidence of whooping cough is cyclical; that is well known. In some years, the incidence rises, as it is doing this year not only in the United Kingdom but in several other European countries—countries that have far better health systems that perform far better than our health service. The difference is that the measures they have taken to curtail this and reduce the prevalence are working far better than our own strategy, so we need to re-examine our strategy. So my question is: what other public health measures are we considering to effectively address the rising rate that is occurring in this country, which is now falling in other countries where it was rising?
Lord Evans of Rainow (Con)
The noble Lord, as always, makes a very powerful point and he is exactly right. Whooping cough is cyclical. The last time this country experienced an outbreak was 2016 and we were due to have another outbreak in 2021. As noble Lords will know, we suffered from Covid lockdown and because of the isolation, it went down. So we were due one in 2020-21, and the reason that this outbreak is more powerful is because of social distancing during Covid—and the outbreak is the most severe, as the noble Baroness said, in a long time. That is the explanation—it is cyclical, we had lockdown and we are now in the middle of the severe outbreak.
As for the noble Lord comparing our health service to others throughout Europe, he is exactly right. The UK has the most extensive immunisation programme in the world but, as he rightly points out, we have to communicate that to all the population. NHS England works with UKHSA and the regions to continuously review opportunities to improve uptake and coverage of all NHS routine immunisation programmes, sharing and spreading best practice in what has worked. But we can always learn from other countries to make the NHS even better.
Medical Student Places
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
The noble Lord raises an important point about the number of doctors, but I fear I am repeating myself. The Government have laid out in their long-term NHS workforce plan that we will have a significant increase in the number of doctors—from 7,500 each year, in five new medical schools. So that may have been the case in the past, but it will not be in the future through to 2030-31.
Lord Patel (CB)
My Lords, the training of doctors requires expansion of resources in pre-clinical years and particularly clinical years. It also requires expansion of foundation year one and the useless foundation year two, which are clinical years in which they train in hospitals and GP practices. What are the Government doing to finance both the clinical years and the foundations years?
Lord Evans of Rainow (Con)
One of the reasons why we cannot accelerate the training of doctors in GP practices, for example, is capacity. That is why the Government have funded five new training hospitals. The noble Lord is absolutely right, but it is about capacity and that is why we are ramping it up, and it will increase in time as outlined in my initial Answer.
Lung Cancer Medicines
Debate between Lord Patel and Lord Evans of Rainow(3 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
My noble friend raises a very important point about communication. When patients are in receipt of drugs and surgery, it is a very vulnerable time, and it is important they are communicated to in an appropriate manner. Takeda has worked closely with the MHRA, the NHS, and the clinical and patient communities to ensure that details of the withdrawal have been appropriately communicated to the lung cancer community. There is also a direct communication to healthcare professionals, to be distributed together with details of compassionate use programmes. This drug will still be available currently and in the future. Regarding efficacy, it is important that, when drugs are brought to the market, they are successful and do what they were brought on the market to do. If that is not the case, they need to come to an end, unfortunately.
Lord Patel (CB)
The Minister is correct when he says the drug is being withdrawn because it did not meet the end-point. We should remember that the drug was marketed with advanced approval because the phase 2 trials were so effective. Because this drug is being withdrawn worldwide and there are alternatives available, it is important that NICE revises its guidance to include other drugs, including other immunotherapies that are effective for non-small cell carcinoma, which this drug was approved for.
Lord Evans of Rainow (Con)
I am most grateful to the noble Lord for his lifelong service to the community and to this House. He raises a very good point. On the one hand, NICE is clear that there are alternatives to this drug, but it will still be available to current patients. I take on board what the noble Lord says, and I will report it back to the department.
Vector-borne Diseases
Debate between Lord Patel and Lord Evans of Rainow(5 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
My noble friend is exactly right. When you go walking in the UK, not just in Scotland, it is always advisable to take insect repellent. The UKHSA will collaborate, and indeed is collaborating, with UK government departments and devolved Governments to make sure that the evidence emerging across the United Kingdom can be collected, because, other than mosquitoes, ticks bring diseases.
Lord Patel (CB)
My Lords, as long ago as 2016, the House of Lords Science and Technology Committee produced a report on the genetic modification of insects for protection of crops, and its possible application, as the noble Lord, Lord Winston, has already mentioned, to vector-borne diseases in humans. The only start-up company following research, which was based in Oxford, had to move to California because of lack of support. It now does field trials, which are the important part of testing any research that is carried out, to see if something is effective and to set a benchmark. The field trials are carried out in Brazil and other countries. With the threat of further insect-borne diseases such as dengue, chikungunya and Zika, is in not time that we invested more money in research to investigate how we can reduce the harm caused by vector-borne diseases?
Lord Evans of Rainow (Con)
The Government are doing exactly that and investing significantly into research. In terms of any private sector business that is looking into this, they should please contact me or the government department and we will work with them. If there is any research and development that we are not aware of, we are very keen to hear about it.
NHS: General Medical Practitioners
Debate between Lord Patel and Lord Evans of Rainow(6 months, 1 week ago)
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Lord Evans of Rainow (Con)
I do not have an answer in my pack to that specific question, but the noble Lord raises a very good point. It is very important that we bring more specialist skills into primary care, and GP practices are exactly the right place, but I will come back to the noble Lord on that specific point.
Lord Patel (CB)
My Lords, what assessment have the Government made of the number of general practitioners required to meet the needs of the population and for training purposes by the year 2030?
Lord Evans of Rainow (Con)
We are working with NHS England to increase the general practice workforce in England but, as the population grows, with the amount of building that goes on throughout the country, it is the responsibility of local authorities. There are two ways to do this: they can apply for capital funding for new GP practices; or they can apply through Section 106 agreements through local authorities. It is for the regions and for local authorities to plan ahead on that front.
Metastatic and Secondary Breast Cancer
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
I am grateful to the noble Baroness for raising that very important point; she is absolutely right. I cannot answer that specifically, but I can certainly take it back to the department and write to her.
Lord Patel (CB)
My Lords, going back to the Question, it is encouraging that breast cancer outcomes have improved tremendously and that 85% five-year survival is what is now expected. However, this is not the case for two groups of patients: those with metastatic disease and those who are triple negative to oestrogen, progesterone and HER2 receptors. Can the Minister confirm that innovative modern drugs, including immunotherapy, should be available to these groups of patients throughout England?
Lord Evans of Rainow (Con)
The noble Lord is exactly right. I can confirm that if there any drugs that should be made available, they will be. As I said previously, if there are any specific drugs the noble Lord has in mind, I ask him to please let me know and I will take it back to the department and make sure that they are available, if appropriate.
Drugs: Supply and Availability
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
Community pharmacies play a vital role in our communities. I will certainly take on board what the noble Lord has said and look into that.
Lord Patel (CB)
My Lords, all of us want the UK to be the best place in the world for excellent, new and innovative medicines. However, the pharma industry has complained about uncompetitive rebate rates for both voluntary and statutory schemes. Added to that, it has found it difficult to launch new medicines in the UK, and there is a great variation of availability to patients of medicines appraised by NICE of as much as 51%. What are the Government doing to address all these problems with solutions, so that patients can get the medicines they need?
Lord Evans of Rainow (Con)
The Government work closely with NICE on a multitude of new medicines and do a very good job of bringing them to the patients of need. If the noble Lord has any specific issues about any particular drugs, I can certainly look into that on his behalf.
Respiratory Syncytial Virus Immunisation
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
The noble Baroness raises a very good point. She is absolutely right that the Government and the NHS have to use all media channels to make sure that people are aware of what is available. We have some new products coming through, one example of which is nirsevimab, which provides longer-term protection than its recently used predecessor of five months compared to one month. We try to communicate these, so that people do not have to go so regularly for immunisation. We hope that that one immunisation can cope with the winter season.
Lord Patel (CB)
My Lords, can the Minister clarify that no vaccine is currently available for RSV and that the only available preventive measure for the disease is, as he mentioned, monoclonal antibodies, particularly for children? Does he agree that the disadvantages include that it requires multiple injections, and therefore will be administered only to higher-risk children at this stage, and that we will have to wait until a vaccine is developed before we can move the programme to all children?
Lord Evans of Rainow (Con)
The noble Lord is exactly right. Unfortunately, I cannot report to the House that we have a new vaccine, but my understanding is that they are working on it. As I said in my previous answer, nirsevimab lasts five times longer, so you do not have to have those injections as regularly—but I am afraid that you do still need to have them.
Cancer Therapies Access
Debate between Lord Patel and Lord Evans of Rainow
Lord Evans of Rainow (Con)
My Lords, NHS England commissions selective internal radiation therapy as a treatment of choice for patients with unresectable advanced hepatocellular carcinoma in accordance with technology appraisals and metastatic colorectal cancer in accordance with the NHS England clinical commissioning policy. It should be noted that the market engagement and prior information notice process permitted any NHS trust that hosts a specialist liver service and multidisciplinary team to put themselves forward, either independently or in partnership with other NHS trusts.
Lord Patel (CB)
My Lords, Cancer Research UK published a report last week that shows that, by 2040, we will have half a million new cases of cancer. Considering that the UK has the worst record on cancer outcomes in western Europe and that we are not likely to meet the Government’s target of diagnosing 75% of new cancers at stage 1 or 2, why did the Minister in the other place state that the Government are to abandon the 10-year cancer plan, particularly when the previous Secretary of State wanted a new plan which was more challenging and robust?
Lord Evans of Rainow (Con)
My Lords, improving early diagnosis of cancer is a priority for the NHS. That is why one of the core ambitions of the NHS’s long-term plan is to diagnose 75% of cancers at stage 1 or 2 by 2028. November 2022 saw the highest number of urgent GP referrals for cancer ever, with nearly 265,000 patients referred, representing 125% of November 2019 levels on a per working day basis, compared to the pandemic low of 80,000 in April 2020. It is a priority of this Government for the NHS.
Lord Evans of Rainow (Con)
My Lords, looking ahead, a number of specialised services will be delegated to integrated care boards, which in turn will want to work with and through local cancer alliances to plan and organise access to cancer services, including specialised services such as SIRT and non-specialised services such as highly intensive focused ultrasound. Following delegation, NHS England will remain the accountable commissioner for all prescribed specialised services and will continue to determine national standards, including new treatments.
Lord Patel (CB)
My Lords, I am sorry to come back, but the Minister did not answer my question, which was: why are the Government abandoning the 10-year cancer plan? Is it to be replaced with a new plan, or is it totally abandoned?
Lord Evans of Rainow (Con)
My Lords, we have not abandoned anything. It is all part of the Government’s strategy to improve cancer outcomes.