Oral Answers to Questions

Debate between Andrew Gwynne and Jane Ellison

Tuesday 5th July 2016 Commons Chamber

[Jane Ellison]

My hon. Friend is right to champion these new technologies. In fact, the Department has already invested in research into CRP. We look forward to seeing what that brings and, in due course, to seeing how it might move forward. It is very much already on our radar.

[Andrew Gwynne (Denton and Reddish) (Lab)]

There is an impending public health issue in this regard, not least with strains of gonorrhoea, for example, that are starting to show resistance to antibiotics. A number of doctors are incredibly concerned about this. What more can be done to incentivise research and development to ensure that this public health concern does not become a public health crisis?

[Jane Ellison]

The hon. Gentleman, who knows a great deal about these matters, is right. Incentivising discovery is absolutely at the heart of the O’Neill review. O’Neill has made a series of recommendations about unblocking the drugs pipeline, and we will respond to that in full. It is a critical issue. In the meantime, conservation of the antibiotics we have and sensible prescribing is critical to making sure that, as the hon. Gentleman says, drug-resistant strains of gonorrhoea, for example, do not take hold.

NHS Commissioning (Pre-Exposure Prophylaxis)

Debate between Andrew Gwynne and Jane Ellison

Tuesday 7th June 2016 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

(Urgent Question): To ask the Under-Secretary of State for Health if she will make a statement on NHS commissioning in relation to HIV pre-exposure prophylaxis.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I am grateful for the opportunity to respond to this urgent question. As the House knows, HIV can be a devastating illness, and we know that pre-exposure prophylaxis—PrEP—can make a difference to those at risk of contracting HIV and to those who are already HIV positive. However, it is crucial that we have a full understanding of all the issues surrounding PrEP.

As with any new intervention, PrEP must be properly assessed in relation to clinical effectiveness and cost-effectiveness. That is why we have today asked NICE to conduct an evidence review of Truvada for PrEP of HIV in high-risk groups. This evidence review signifies the next step forward and will inform any subsequent decisions about commissioning. It will look at the evidence for effectiveness, safety, patient factors and resource implications. The NICE evidence summary will run alongside a pilot scheme in which we are investing up to £2 million. Public Health England is currently identifying the most effective places for the pilot to take place.

It is also important to remember that Truvada, the drug used for PrEP, is not yet licensed for this use in the UK. That is why, as well as the pilot scheme, the Government want to see the evidence review, which will help to inform future commissioning decisions about PrEP.

PrEP is only one of a range of activities designed to tackle HIV, which is of course a Government priority. It is also important to stress that the challenge remains of tackling high rates of some sexually transmitted infections, particularly in high-risk MSM—men who have sex with men—communities. Our £2.4 million national HIV prevention and sexual health promotion programme gives those at highest risk the best advice to make safer choices about sex.

The UK has world-class treatment services and is already ahead in reaching two of the three UNAIDS goals of ensuring that we have 90% diagnosed infection, 90% of those diagnosed on treatment and 90% viral suppression by 2020. In 2014, 17% of those living with HIV had undiagnosed infection, but 91% of those diagnosed were on treatment, of whom 95% were virally suppressed. We are determined to continue to make real progress to meet these goals, and we are considering carefully the role that PrEP can play in helping us to get there.

[Andrew Gwynne]

I thank the Minister for that reply. This is a subject we do not debate enough in the House, and I am grateful to Mr Speaker for giving us the opportunity to debate it today.

Seventeen people are diagnosed with HIV every day. Each year, there are thousands of new infections. In the UK, there are more people living with HIV than ever before. We know that PrEP has the potential to be a game-changer—it has proved effective in stopping HIV transmission in almost every case—yet as a result of this latest decision, this life-changing drug will remain inaccessible to people at risk of HIV. Does the Minister therefore share my concern about the precedent this decision sets in terms of NHS England shunting other preventive costs on to local government? Will she explain why pre-exposure prophylaxis is being dealt with differently, compared with the correct commissioning model for PEP, or post-exposure prophylaxis?

I want to ask the Minister three specific questions. First, does she accept that, under section 7A of the National Health Service Act 2006—a mechanism by which the Secretary of State can delegate power—the Health Secretary can give NHS England the power to commission PrEP? If so, why has he not done so? Secondly, if the Government expect local authorities to commission PrEP, how much additional funding will the Minister make available to them? Can we assume that there will be no further cuts to public health grants, or is this just a case of passing the responsibility and the financial buck? Thirdly, on the next steps, I understand that key stakeholders, including the National AIDS Trust, have written a joint letter to the Public Health Minister requesting an urgent meeting. Will she today agree to meet them to see whether a way forward can be found without the need for costly, protracted legal action?

PrEP has been described as the beginning of the end for the HIV epidemic. It is time for the Minister to show some leadership, to use the section 7A powers she has and to think again.

[Jane Ellison]

Some of the shadow Minister’s questions are simply ahead of the moment, as it were. As I said clearly in my statement, NHS England has made clear how it feels about being the commissioner, based on a legal argument that it has published. No decision has been made about who the commissioner is. Clearly, we need to reach a decision, and we discussed that earlier today in the Health Committee. However, there are a number of stages we have to go through—as I say, the drug is not even licensed for use as PrEP in the UK.

We have set out a series of stages we will go through, which will help to inform a final decision. On the questions the hon. Gentleman posed, we are not in a position to make a judgment. There is more we need to know about clinical effectiveness and cost-effectiveness and about the pilot—

[Andrew Gwynne]

We know.

[Jane Ellison]

No, that is not the case. There has been an important study—the PROUD study—but that looked at clinical effectiveness. There is a wider piece of work to be done—of which the pilot programme that we have announced is part—to enable us to understand where PrEP fits in in terms of clinical and cost-effectiveness, and how it fits into the HIV prevention landscape more broadly, alongside other HIV interventions that are commissioned. There is work yet to do, but we are not standing still. We have announced this important pilot and committed money to it, and we have asked NICE for an evidence review. All this will go into our consideration.

Oral Answers to Questions

Debate between Andrew Gwynne and Jane Ellison

Tuesday 9th February 2016 Commons Chamber

[Jane Ellison]

There is rightly a great deal of attention on this area—more tier 4 beds have been commissioned, for example—but I want to stress what is being done in my area of public health. Right at the heart of our new tobacco strategy, which we are beginning to work on, is a concern for the inequity facing people suffering from mental ill health in terms of smoking levels. I can reassure the hon. Lady that across the piece we are considering how we can do more for those who suffer with mental health problems.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Access to contraception is not only a fundamental right but a cost-effective public health intervention—every £1 spent on contraception saves the NHS £11—yet the Government are presiding over savage cuts to public health services. It is predicted that £40 million will be cut from sexual health services this financial year alone. Is that what the Minister means when she says the Government are serious about prevention? Why does she not finally admit that these cuts not only make no financial sense but could put the nation’s health at risk?

[Jane Ellison]

I reject that analysis. It is for local authorities to take decisions on local public health spending, but they are mandated by legislation to commission open-access sexual health services that meet the needs of their local population, and in fact there is a great deal of innovation around the country in how people are doing that. For example, in Leeds, they are redesigning services to enable people to access sexual health. [Interruption.] The shadow Minister laughs, but the question of how much they would have invested in the NHS goes unanswered by the Opposition—a question that was never answered at the general election. On prevention, as I have said, the public health grant is not everything. In the next financial year alone, for example, the Department will spend £320 million on vaccines. We have introduced two world firsts: the child flu programme and the meningitis B immunisation programme. Right across the piece, this Government are investing in prevention and in our NHS.

Infected Blood

Debate between Andrew Gwynne and Jane Ellison

Thursday 21st January 2016 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I thank the Minister for her statement and particularly for advance notice of her intention to give it and for providing me with early sight of it.

I appreciate that this is a difficult issue, but I think that the Minister’s approach today has been the right one, and we will welcome what she has said. She was right to apologise on behalf of the Government, and I would like to echo that apology, because successive Governments of all colours have failed to respond adequately to this scandal. In many ways, this failure has only deepened the injustice felt by the victims.

I want to pay tribute to all Members who have been a strong voice for the victims of contaminated blood. I would like to mention, in particular, my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), the hon. Member for Worthing West (Sir Peter Bottomley), my hon. Friend the Member for Hammersmith (Andy Slaughter), the hon. Member for South Down (Ms Ritchie), the right hon. Member for North East Bedfordshire (Alistair Burt) and indeed my right hon. Friend the Member for Leigh (Andy Burnham).

This scandal saw thousands of people die, and thousands of families destroyed through the negligence of public bodies. Although the Minister was absolutely right to say that no amount of money could ever make up for the impact this tragedy has had on people’s lives, we all owe to those still living with the consequences the dignity of a lasting settlement. With that in mind, I want to press the Minister on four points.

First, on funding, it was claimed that one reason for delaying the announcement of this consultation was to achieve clarity about how much funding would be available, following the comprehensive spending review. The Minister appeared to announce an additional £100 million for the new scheme, so for further clarity, will she set out the total amount that will be available over the lifetime of the new scheme, and how that compares to the previous scheme?

Secondly, we welcome the fact that the consultation will offer the choice of a one-off lump sum payment for the bereaved, but will the Minister say a bit more about how that might be implemented? As she knows, these payments will enable choice, and it is important that we get this right.

Thirdly, will the Minister say a bit more about widows and widowers? She will know that the Scottish review group recommended that widows should get some form of pension for the first time. Has she considered this option? It is important to recognise that widows and widowers are suffering not only from an immediate loss of income from their partner, but from the inability of their partner to save for a pension or get life insurance over the past few decades.

My final question is about the status of hepatitis C sufferers who have not developed liver cirrhosis. We welcome the possibility of ongoing payments, but can the Minister say how the assessments will work? In particular, it is important that these assessments take account of the longer-term health impacts of living with hepatitis C. Does the Minister have any figures on how many of these individuals will not have access to the new hepatitis C treatments? Given that the NHS made these people ill, and the NHS has the drugs available to help these patients, it does seem wrong that we are denying some of these people treatment—the treatment that they both need and, frankly, deserve. Will the Minister say a bit more about how the Government intend to improve access to treatment specifically for these individuals?

I hope that everyone affected will be able to take part in this consultation and have their say on the future reform of the scheme. The Minister will have our full support in implementing that new scheme and doing what we can to provide relief for the victims of this terrible injustice.

[Jane Ellison]

I thank the shadow Minister for responding in those terms. It is much appreciated. As he says, we all want to try to move forward with a consensus in support of the people affected by this tragedy. I will try to respond to his questions, although I might have to write to him on one of them because my on-the-spot maths is not quite good enough.

On funding, as I have made clear several times before, the money will come from the Department of Health budget, and we have identified an additional £100 million over this spending review period, which allows us to double the current spend on the existing schemes. This is in addition to the £25 million announced in March 2015. Spend to date is £390 million and the projected future spend is £570 million, so together with the £100 million and the £25 million, that amounts to more than £1 billion over the lifetime of the scheme. I hope that provides the hon. Gentleman with some clarity on funding.

The hon. Gentleman asked about lump sums. It can be seen in the consultation documents that we are consulting on options for both those already bereaved and those who will be bereaved in the future, and we are asking people how they feel about continuing with a discretionary approach or taking a one-off payment that would be based on a multiple of the discretionary payment they get in the current financial year—or indeed a hybrid of the two. We are trying to be as open as possible, so people can give us their views on how they see the way forward.

I have seen the Scottish proposals and I had a conversation with my opposite number in Scotland this morning before I came to the House. Because one of the options for bereaved people is an ongoing payment, albeit a discretionary one, I would not compare it with what I understand the reference group in Scotland has put forward as a pension. Obviously, we are talking about access to ongoing but discretionary payments. Again, I look forward to hearing the views expressed during the consultation on that issue.

It might be helpful for Members to know that 160,000 people in England have hepatitis C. Those affected by this tragedy make up fewer than 2% of the hepatitis C population in England. The NHS has to treat people on the basis of clinical need. The treatments are in the region of £40,000 each—quite expensive treatments. However, we believe more treatments are in the pipeline, which is one reason why I am so keen to ensure that clinical expertise is embedded within the new scheme. We are particularly keen to understand, in respect of the people who do not quite reach the current NICE guidelines for rolling out treatment in the NHS, whether, by recognising the unique circumstances of the people affected by this tragedy, we can do something within the scheme to support them. We need to understand how many people will be interested. Members might find it helpful to know that while not every genome type of hepatitis C is susceptible to the new treatment, the majority, thankfully, are. For some people, none of the new treatments is clinically appropriate.

I think I have dealt with the key questions that the hon. Gentleman asked me. I would be happy to carry on working in the spirit in which he responded to my statement and come back to him with any further clarity that he seeks subsequent to this debate.

Oral Answers to Questions

Debate between Andrew Gwynne and Jane Ellison

Tuesday 5th January 2016 Commons Chamber

[Jane Ellison]

I absolutely join my hon. Friend in that and agree with his very well-deserved words of congratulation. I know that the Under-Secretary of State for Life Sciences has visited the institute and is—as everyone is—hugely impressed with it. I also join my hon. Friend the Member for Lichfield (Michael Fabricant) and others in congratulating Charlie Craddock on his CBE in the new year honours list.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Patients living with rare cancers often have fewer treatments available to them. Often, the only option is to use off-label treatments. The cancer drugs fund has helped patients gain access to those treatments, but, despite a Conservative party manifesto commitment to continue investing in it, the fund is now under threat because of central Government cuts. What assurances will the Minister provide to people living with rare cancers that off-label drugs will still be funded? Will she apologise for the uncertainty that those cuts are causing to the thousands of people who are affected by cancer in England?

Victims of Contaminated Blood: Support

Debate between Andrew Gwynne and Jane Ellison

Wednesday 16th December 2015 Commons Chamber

[Jane Ellison]

My hon. Friend, who has campaigned long and hard on this issue, is right to reiterate the importance of the views given in that report. I confirm that they have already informed our thinking about how we go forward, as indeed have the views of many colleagues on all sides of the House expressed over many months and years. I can assure him that the report will be considered. I have previously committed, and I reiterate the commitment today, to conducting a root and branch reform of the current schemes.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Thank you, Mr Speaker, for granting this urgent question. I pay tribute to all the Members of this House who have been a strong voice for the victims of contaminated blood, but in particular to my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) who has been tireless in her pursuit of answers.

This scandal saw thousands of people die and thousands of families destroyed through the negligence of public bodies. Over the years, the response of Governments of all colours just has not been good enough. It is a real shame that we are here yet again wondering why action has not been taken. I do not think anyone doubts the sincerity of the commitment that the Prime Minister made back in April, but does the Minister understand the disappointment that people have felt in recent months as promises to publish arrangements and to make statements have been broken repeatedly? Does she accept that that has only raised false hope among a community that already feels very betrayed?

Given the further delay that the Minister has announced today, what guarantees do we have that the January consultation date will be met? What redress—other than an urgent question through you, Mr Speaker—will there be if it is not? A consultation is fine, but will she say when any new scheme will be implemented? It is important that any new arrangements are properly scrutinised, so will she commit to a debate in Government time to allow that to happen? Finally, does the public health Minister appreciate that the longer this goes on, the longer we leave in place a system that is not working and leaves victims without adequate support?

No amount of money can ever fully make up for what happened, but we owe those still living with the consequences the dignity of a full, final, fair and lasting settlement. This injustice has gone on for far too long. The time for action is now.

[Jane Ellison]

As I have already said, I of course regret the delay. This is a very complex area. I appreciate the tone with which the shadow public health Minister responded, because, as he said, Governments of all colours have not turned to this issue. We have turned to the issue and we are addressing it in a great deal of detail. It is a complex area. There is a very diverse range of affected groups impacted by this tragedy and we must get the consultation on reform right for all of them. I have been clear, in my response to the urgent question, that we have been considering the funding issue. We are, of course, aware of potential litigation in relation to the scheme as it stands. I cannot comment further on that, but the House will appreciate that that adds a level of complexity to dealing with this matter.

I am always extremely happy to come to the House to explain. The scheduling of debates in Government time is not a matter for me, but it goes without saying not only that I would be delighted to debate the matter but that I am happy to talk to colleagues, including shadow Front-Bench colleagues, privately or otherwise, about this matter. That commitment remains.

Oral Answers to Questions

Debate between Andrew Gwynne and Jane Ellison

Tuesday 7th July 2015 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

My hon. Friend has been an extremely active champion of healthcare services for her local community, and I congratulate her on continuing to raise this matter. The CQC is due to publish the findings of its latest inspection of the NHS trust shortly, and we expect the trust to work closely with the regulators to deal with the concern that has been expressed. I know that there is concern locally, and I believe that Polegate Town Council will be discussing the matter soon.

[Andrew Gwynne (Denton and Reddish) (Lab)]

We have heard a number of fair questions from Opposition Members, and, I am afraid, nothing but woeful and inadequate answers from Ministers so far. Let me try again by asking the Secretary of State about GPs. As we have already heard, before the election he promised that there would be an additional 5,000 GPs by 2020. However, now that the election is over, he says that that promise requires “some flexibility”, and he was similarly evasive in an earlier answer. Given that there is, in the words of the Government’s own taskforce, a “GP work force crisis”, will the Secretary of State now clear things up? By 2020, will there be 5,000 extra GPs—on today’s figures—as he promised, or is this yet another example of the Conservatives not being straight with people on the NHS?

Health and Social Care

Debate between Andrew Gwynne and Jane Ellison

Tuesday 2nd June 2015 Commons Chamber

[Jane Ellison]

No, I cannot give way at this moment.

The coalition Government had an excellent record on cancer. Yes, there is further to go, and that is why we have made it central to our plans. We want to see the NHS go further and faster on diagnostics. That is why NHS England has an independent taskforce looking at this issue. We got its interim report in March. We will get its final report in the summer and we will act on it.

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is bluster.

[Jane Ellison]

The hon. Gentleman says it is bluster. Is it bluster to talk about the £1 billion invested in the cancer drugs fund?