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The Parliamentary Under-Secretary of State for Health and Social Care (Ashley Dalton)
It is a pleasure to serve under your chairship, Ms Furniss. I congratulate my hon. Friend the Member for Washington and Gateshead South (Mrs Hodgson) on securing this important debate, and I thank all hon. Members for their powerful words on this emotive topic.
I know that my hon. Friend met with the Minister for Patient Safety, Baroness Merron, last November to discuss the transparency of industry payments to healthcare practitioners, one of the nine recommendations that the independent medicines and medical devices safety review put to the then Government in 2018. This is something that the Government take extremely seriously. We must ensure that lessons are learned, and that is why we are putting patient safety at the heart of improving our health and social care system. I will continue to build a system that listens, hears and acts with speed, compassion and proportionality.
I want to repeat the apology that the previous Government made, which was echoed by my predecessor, the hon. Member for Gorton and Denton (Andrew Gwynne), and by Baroness Merron. I say to all of those mentioned today—to Samantha and her family; to my hon. Friend the Member for Washington and Gateshead South’s mam; to the constituents of my hon. Friends the Members for Leeds South West and Morley (Mark Sewards) and Stoke-on-Trent North (David Williams), my hon. and learned Friend the Member for Folkestone and Hythe (Tony Vaughan) and the hon. Member for Chichester (Jess Brown-Fuller); to Karen from Harrow East; to Bev from Bury North; to Colleen, Andy and Byron from North West Norfolk; to Paula and Gillian from Bexleyheath and Crayford; to Paula Goss; and to all those affected in the Gallery and across the country—we are sorry. We are sorry for the time the system took to listen to you and to your families. Everyone who has suffered complications from sodium valproate and pelvic mesh implants has our deepest sympathies and our assurance that we have listened and will continue to listen to those affected.
I am grateful to the Patient Safety Commissioner, Dr Henrietta Hughes, and her team for the Hughes report, which was published just over a year ago. It built on the important work started by Baroness Cumberlege in 2020. We will continue to work closely with Dr Hughes on how best to support affected patients and prevent future harm, on both this issue and a number of others.
The independent medicines and medical devices safety review was among the first of its kind, shining a searing spotlight on the harmful side effects of certain medicines and medical devices, including sodium valproate and pelvic mesh. The Cumberlege review revealed grave systemic issues in our health system that needed to be addressed with urgency. They covered areas ranging from the healthcare system’s lack of engagement with patients to the lack of safety monitoring for devices once they are on the market. That is why we are working to improve how the system listens and responds to concerns raised by patients; to strengthen the evidence base on which decisions are made; and to improve the safety of medicines and medical devices.
Recommendation 8b of the IMMDS review stated that there should be mandatory reporting for industry payments made to the health sector, akin to the Physician Payments Sunshine Act in the US. The previous Government accepted that in principle and held a six-week consultation. I recognise the importance of transparency and trust in the health system, and the Department is considering options regarding payment reporting, with an aim to publish a response later this year.
I absolutely understand why colleagues are pushing for clarity on our response to the Hughes report. I am acutely aware that this is a difficult and sensitive topic, and I appreciate frustrations about timescales, but this should not be rushed. The Government will need to consider carefully all the options and the associated costs before responding to the report’s recommendations. I assure Members that we will continue to progress this work across Government, ensuring that lessons are learned, and I will commit to writing to Baroness Merron on the timescales, as requested by so many Members today.
Sir Julian Lewis
I think it is true to say that the author of the Hughes report anticipated that the Government would want to take their time over these matters, but that is why Dr Hughes—and Baroness Cumberlege, I believe, as well—recommended an interim payment. If at least that interim payment could be made, people might be more patient about the bells and whistles that have to be added to the response later.
Ashley Dalton
I do appreciate the frustrations. Since we came into government last July, patient safety has been, and I can confirm that it remains, a top priority for this Government. Although it has been a year since the publication of the Hughes report, this is a complex issue involving several Departments, and it is important that we get the response right. As I have said, I will commit to writing to Baroness Merron on timescales, as requested, to get further clarification on that, and we are committed to learning from other instances in which patient safety has been impacted. The infected blood inquiry was mentioned by the right hon. Member for Salisbury (John Glen).
John Glen
I am extremely grateful to the hon. Lady for giving way. I was not trying to suggest earlier that her tenure in office would be short-lived; I wish her every success in her endeavours. I think the spirit of today has been about cross-party consensus, not seeking to make political points about this matter, but what I will say to the Minister is that she can go back to her officials and say that there are two very recent precedents for interim payments, under the infected blood compensation scheme, of quite significant numbers. They were maximised, so that there would be no loss to the public purse—that is to say, they were entitlements that everyone would have been able to receive. That mechanism is there, so this can happen sooner. I recognise what the Minister is saying and I wish her well in her endeavours, but she should be able to do something with that information.
Ashley Dalton
I assure the right hon. Member that we are working at pace on this. It is a complicated matter, and we are taking note of previous similar situations. I assure him and the rest of the House that we will be updating the Patient Safety Commissioner at the earliest opportunity. I appreciate that it is frustrating that I cannot give an exact date or timescale in this debate, but we are working to make sure that we get this right.
Bob Blackman
The Minister is absolutely right in saying that patient safety must be at the forefront. However, we know that 40% of babies whose mothers took these drugs have developmental problems and one in nine have severe handicaps following birth, yet the drugs are still being prescribed to pregnant women. Will the Minister have a look at what can be done to make sure that pregnant women who suffer from epilepsy can at least be advised about the position and then decide whether they want to take the risk or not?
Ashley Dalton
I am encouraged that the number of women still being prescribed sodium valproate has reduced significantly following the Medicines and Healthcare products Regulatory Agency’s introduction of the valproate pregnancy prevention programme. In April 2018, 27,441 women aged under 55 were prescribed valproate in England, but in March 2024, that number had come down to just under 16,000—a reduction of 42%. Nobody should stop taking valproate without advice from their healthcare professional. Beyond lowering prescription rates, I am also grateful to see Dr Rebecca Bromley, who is in the Public Gallery, heading up the foetal exposure to medicines service pilot study. The study is running for 18 months and was commissioned by NHS England. It is a multidisciplinary clinical service that is providing expert assessment, diagnosis and advice to individuals harmed following exposure to sodium valproate. We recognise those concerns.
Patients know what support they need. The Government are determined to make sure that patients feel, and are, truly heard, and to give them more choice and control over their healthcare. The Patient Safety Commissioner rightly sought views from those affected about the issues they are facing with service provision and what support they feel would be most valuable. Hearing from patients is at the heart of our consideration of the Hughes report, which is why Baroness Merron held a roundtable in December with groups representing patients impacted by sodium valproate and pelvic mesh. I know she remains extremely grateful to all attendees for sharing their stories and those of the patients that they represent.
I am aware of the time, and there are many issues that I have been unable to cover in the short time available. However, I commit to writing to all hon. Members who have raised specific concerns. Words cannot express how sorry we are to the women who have suffered from severe and life-changing complications from both sodium valproate and pelvic mesh. We are actively considering this issue, and I wish there were more I could say at this time. I have heard the calls for swiftness, clarity and boldness in the commissioner’s recommendations, and I shall bring that forward at the earliest opportunity. I am sure that this is not the last time this important topic will be discussed, and I know that colleagues will continue to hold our feet to the fire until this gets done.