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The Minister for Health and Secondary Care (Will Quince)
It is a pleasure to serve under your chairmanship, Ms McDonagh. Let me first congratulate my hon. Friend the Member for Gedling (Tom Randall) on securing a debate on this hugely important issue. I know that he is a tireless campaigner for those living with arthritis, in particular axial spondyloarthritis, and his experience is invaluable in bringing a voice from that community to this place. He made a very emotive and powerful case in his usual articulate and eloquent way. I would also like to thank him for sharing his constituent Elizabeth’s experience, which shows how much further we still have to go in supporting people with this condition.
I would also like to pay tribute to the outstanding charities that support the 10 million people living with arthritis in the UK. I know that my hon. Friend works closely with the National Axial Spondyloarthritis Society—the NASS—and many other charities, such as Versus Arthritis and the National Rheumatoid Arthritis Society, which do such fantastic work to support patients and drive improvements in care. He referenced arthritis week—those charities have collectively made arthritis week a resounding success and do stellar work raising awareness not just during that week, but all year round, as my hon. Friend rightly pointed out.
My hon. Friend is also absolutely right to point to the impact that arthritis has on not only people suffering from the condition, but their families and carers. I know from my own experience of growing up with my grandmother, who lived with rheumatoid arthritis, the impact it had not only on her, but on my mother and the wider family. He is also right to highlight the difference that early diagnosis, the quality of care and proper support can make. He raised a number of important points in this debate; I will turn to each one now.
My hon. Friend made a hugely important point about early diagnosis of the condition and set out some of the challenges. He is right to stress the difference that early diagnosis can make to long-term quality of life. Research from charities shows that one year, rather than eight years, to diagnose inflammatory arthritis can save individuals over £150,000 in lost income and medical expenses. I know that NHS England is working hard to improve early diagnosis rates through its GIRFT—getting it right first time— rheumatology programme, which is designed to improve the diagnosis, treatment and care of patients, but I appreciate and recognise that we have further to go on this. I would be very happy to work with my hon. Friend to see what further improvements we can make alongside NHS England.
In terms of treatments for arthritis, the Government are committed to supporting timely and, vitally, consistent access to effective new medicines for NHS patients with arthritis. The National Institute for Health and Care Excellence has recently recommended several new medicines for arthritis and other rheumatological conditions, including Rinvoq, Tremfya and Skyrizi. These allow patients to benefit from pain reduction and an improved quality of life and are now, I understand, routinely available for clinicians to prescribe to eligible NHS patients in line with NICE recommendations.
My hon. Friend was generous in setting out details about the major conditions strategy, and I agree with so much of what he said. In January of this year, we announced our plan to publish the major conditions strategy, which is designed to tackle the key drivers of ill health in England. We have now published our initial report, “Major conditions strategy: case for change and our strategic framework”, which sets out our plan to promote prevention of non-pharmaceutical interventions. The idea is to create a truly personalised approach for patients. I can assure my hon. Friend that my firm commitment is to continue engaging with charities such as Versus Arthritis and the NASS as we develop that strategy going forward. That is absolutely right; in fact, it is critical that we work with those charities to ensure that we are getting it right as we develop the strategy.
I would also like to touch on gene and cell therapies. In my view, having looked into this not just in relation to arthritis but more broadly, they have huge potential. I am passionate about the UK’s status as a life sciences superpower, and I am really pleased that the Medicines and Healthcare products Regulatory Agency has launched the innovative licensing and access pathway to reduce the time it takes to get innovative medicines to market. In April of this year, the National Institute for Health and Care Excellence recommended Upstaza for aromatic L-amino acid decarboxylase deficiency, which is a horrific genetic disorder affecting children. That is the first gene therapy for children with that condition, which is administered directly into the brain through a minimally invasive procedure.
My hon. Friend touched on elective recovery, and he is right to do so, because we know the size of the waiting list and the impact that has on patients. He rightly raised the waiting times for operations that patients often need, such as joint replacements. Of course, alongside that, it will not have escaped his notice that cutting wait lists is one of the Prime Minister’s five priorities. That is why we are putting record staffing numbers and record levels of funding into our health service. We are spending over £8 billion from 2020 to 2025, plus an additional £5.9 billion specifically for capital projects: funding for new beds; new tech and equipment; community diagnostic centres; and surgical hubs. We have virtually eliminated 18-month waits, and from this month patients waiting over 40 weeks will be informed of their right to be treated somewhere with a shorter waiting list—which of course includes those with arthritis and other musculoskeletal conditions. Patient choice is going to be at the heart of that.
My hon. Friend and I have previously had conversations about prescriptions—particularly free prescriptions—the charges for people with arthritis, and the need to review the current medical exemption list. I believe there has been only one addition to the list since 1968, which was specifically for cancer. I apologise for what may be a disappointing response, but we do not have any plans to make another exemption at this time. However, I would say to my hon. Friend and all those raising this issue that around 89% of prescription items are currently dispensed free of charge, and there are already a wide range of exemptions from prescription charges for those who meet the eligibility criteria.
My hon. Friend has also raised the issue of mental health with me in the past, and we know that about 30% of people with rheumatoid arthritis develop depression within five years of their diagnosis, and that 20% of people with osteoarthritis experience depression or anxiety. Of course, those statistics should concern us. That is why we have made it centrally clear to commissioners at the local level that we expect NHS talking therapies to be integrated into physical healthcare pathways. It is absolutely critical that, alongside their physical health, we also support the mental health of patients. Our NHS long-term plan commits to an additional £2.3 billion a year for the expansion of mental health services by 2024, so that an additional 2 million people can access NHS-funded mental health support.
I hope that my hon. Friend will be reassured by some of the measures that I have outlined today. I recognise that we have to go further, and my hon. Friend made a powerful case for that. To respond to his request for me to work with him, alongside NHS England, to explore how we can do that, my door is of course always open to him and other colleagues on this issue. I would like to thank him again for giving me the opportunity to reiterate our commitment to the very highest standards of care for the 10 million people living with arthritis in this country. I will of course look at what more can be done to address the needs of those affected by arthritis. I will take his points away and give them further thought, so that together we can continue to create the kind of care that patients deserve, to allow them to live their lives to the fullest. I would like to close by again thanking my hon. Friend and the charities for all their work in keeping a spotlight on this issue so that arthritis awareness remains constant in the public eye, not just for one week but every day of the year.
Question put and agreed to.