Cancer Drugs: Licensing and Approval

Baroness Masham of Ilton Excerpts

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

It is important that we learn the best lessons from abroad on incredibly important issues such as this. Where NICE and MHRA are allowed to talk to each other and co-operate—there are some restrictions, as I am sure many noble Lords are aware—both clearly recognise that there are great concerns and distress on the part of the many patients who want access to these drugs, and they are trying to work out how they can speed up the process as much as possible.

[Baroness Masham of Ilton (CB) [V]]

My Lords, how can we speed up the process once new, innovative medicines have been approved by NICE so that patients get their benefit? Is the Minister aware that other countries, especially Germany and France, are leading the way with cancer drugs while England is near the bottom of the list? That is not good enough, is it?

[Lord Kamall (Con)]

I thank the noble Baroness. It is important that NICE, MHRA and others hear some of the concerns, and the fact that we are being held to account today shows how important this is. Unfortunately, some existing legislation restricts MHRA’s ability to share information with partners, including NICE, which would help them to plan their processes more efficiently. NICE, MHRA, NHS England and NHS Improvement are talking about the concerns raised by noble Lords and generally about delays in the process. They are talking about how they can improve access, including through initiatives such as the Innovative Licensing and Access Pathway launched in January 2021, and sharing as much information as they can upfront. Both MHRA and NICE are aware of the concerns and made that clear when I met them recently after their board-to-board meeting.

Covid-19 Vaccinations

Baroness Masham of Ilton Excerpts

Monday 8th November 2021 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely and I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, what is the situation with vaccination against coronavirus for inmates and staff in UK prisons? Prisoners often get transferred to other prisons and they move in and out when released and recalled. Many live chaotic lives, but it is important that they all get vaccinated. Is there a system to see that this process is safeguarded, so that jabs are fully completed? Prison health must not be forgotten.

[Lord Kamall (Con)]

The noble Baroness raises a very important point. As far I am aware—I will confirm this—the population of prisons is being treated the same as the wider population in terms of encouragement to take the vaccines and the booster. I will double-check and write to the noble Baroness.

HIV Action Plan

Baroness Masham of Ilton Excerpts

Monday 18th October 2021 Lords Chamber

[Lord Kamall (Con)]

As the noble Lord says, in March 2020 the Government announced that the HIV prevention drug PrEP would be routinely available across England in 2020-21. It is now routinely available in specialist sexual services throughout the country. The settings in which PrEP could be made available outside these health services, such as pharmacies, will be considered as part of the ongoing work on the development of the sexual and reproductive health strategy and the HIV action plan. We plan to publish the HIV action plan later this year to coincide with World AIDS Day on 1 December, and the sexual and reproductive health strategy shortly thereafter.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I welcome the Minister to the fight against HIV/AIDS. Will he agree with me that NHS England, public health, local authorities and voluntary organisations should work together to fight against HIV infection so that it does not become fragmented? Because of the coronavirus infection, many people think that HIV/AIDS has gone away: it has not.

[Lord Kamall (Con)]

I thank the noble Baroness for reminding us that HIV has not gone away. This is why the Government have an action plan. All noble Lords will agree on how important it is to tackle HIV and to raise awareness. The Government hope, in their plan and strategy, to be able to do this as soon as possible, and we remain committed to the goals previously set out.

Covid-19 Update

Baroness Masham of Ilton Excerpts

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend puts it very well. Clearly, with the infection rates rising but with a very large proportion of the country vaccinated, it is worth reviewing this. As the Secretary of State said in his Statement earlier this afternoon, from 16 August the Government intend to exempt people who have been fully vaccinated from the requirement to self-isolate if they are a contact of a positive case, with a similar exemption for under-18s. Anyone who tests positive will still need to self-isolate regardless of their vaccination status. Symptomatic testing will continue to be available. This is a proportionate direction, given the state that we are in.

[Baroness Masham of Ilton (CB) [V]]

My Lords, how much research is being done into long Covid? Many people feel misunderstood and frustrated as they want to get better and many long Covid clinics are not yet open.

[Lord Bethell (Con)]

My Lords, I completely sympathise with the frustration that many feel when they have the symptoms of one of the many syndromes associated with long Covid. According to the ONS, more than 1 million are in that situation. Those symptoms might range from extreme tiredness, aches and pains, to cardiac or respiratory exhaustion. Our fears are that long Covid will be a horrible legacy of this disease. NIHR has half a dozen research projects at the moment, and I understand that it will be looking for more. The clinics the noble Baroness described are being rolled out at speed and I pay tribute to the NHS, which has a 10-point plan for dealing with long Covid. I would be glad to share a copy of that with the noble Baroness.

Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) (No. 2) Regulations 2021

Baroness Masham of Ilton Excerpts

Wednesday 16th June 2021 Lords Chamber

[Baroness Masham of Ilton (CB) [V]]

My Lords, public health is more important than it has ever been, apart from during the Black Death and the Spanish flu. We now have a variant that is more serious than the original coronavirus. The delta variant is relentless and sweeping across the UK. It is attacking young people who have not been vaccinated and are at risk of getting long Covid. It has also put some people who have not been vaccinated in hospital. A young student at school in Gloucestershire told me that the class above his had got the virus, and the class and teacher were isolating. Young people do not want to be spreaders. When can they be vaccinated? Is the problem that there is a shortage of the Pfizer vaccine?

I hope that the Government will think again about senior schoolchildren wearing masks. There is confusion about mask wearing. At the beginning of the coronavirus pandemic, people were told that masks were not necessary. Prevention is better than cure. I send my heartfelt condolences to all the families whose loved ones did not make it. It is a very difficult matter to have to continue with restrictions, but with the rise in infections again, I think that it is the right thing to do.

I am concerned that there are staff working in hospitals, in care homes and visiting people in their own home who have not been vaccinated and do not want to be. They could be putting patients and their colleagues at risk. Perhaps, they should not work in contact with people. Local authorities are given enforcement powers. How are these going to be enforced?

Having read the information for health protection, I am not clear on the outcomes before 19 July 2021. I would be grateful if the Minister could tell the House clearly about air travel, weddings and funerals. How many people are allowed at these functions?

Covid-19 Update

Baroness Masham of Ilton Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I absolutely pay tribute to the Constitution Committee. It was generous enough to have me appear in front of it, and I gave several hours of evidence. I am glad to see that my noble friend read the report; I hope he enjoyed my evidence in it as well. In that evidence I made it absolutely crystal clear that the Government work with the laws at our disposal; that is what we have to hand. There may be a time when Parliament chooses to review those laws. Now is not the time, but when it is we will do it.

[Baroness Masham of Ilton (CB) [V]]

My Lords, is the Minister aware that many people would like to know whether, having had two vaccinations, they have antibodies? Is this possible? Also, there has been a shortage of the Pfizer vaccine. How can this be increased worldwide?

[Lord Bethell (Con)]

My Lords, I agree with the noble Baroness that many are curious about whether they have antibodies, but I warn her that the presence of antibodies does not necessarily correlate with immunity. Some people have strong immunity and no antibodies, and some have antibodies but not immunity. This is one of the mysteries of the body’s response to the disease and one of the reasons why it has been such a confounding disease to fight. But if anyone does want an antibody test, they should ask their GP and it can be arranged.

Covid-19: Variant B.1.617.2

Baroness Masham of Ilton Excerpts

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not quite recognise the world the noble Baroness describes. In fact, I would say that the work between Public Health England, schools, local authorities and local infection teams has never been stronger, and it has proved to be extremely effective. The noble Baroness is right that schools are often a source of infection, and we remember well what happened in September. In areas such as Bolton, we are very careful to ensure that infection measures are put in place. I do not accept that there is an issue of trust.

[Baroness Masham of Ilton (CB) [V]]

My Lords, are people who have not been vaccinated and who are diabetic being warned about the dangers of the deadly mucormycosis, the black fungus, which is associated with the Indian variant—and now there is a white fungus also? Is the Minister aware that antifungal medication for the treatment of these conditions has run out in India? Can the UK help? There are many children who are diabetic.

[Lord Bethell (Con)]

I have read reports about the fungus the noble Baroness describes, and they are absolutely chilling and a source of grave concern. I am not aware of that being a threat to British public health; I feel sure that Public Health England is watching it extremely carefully. I take note of the noble Baroness’s point about medicine being in short supply. I will be glad to look into it more closely and write to her with more details.

Alcohol Harm Commission: Report 2020

Baroness Masham of Ilton Excerpts

Thursday 22nd April 2021 Grand Committee

[Baroness Masham of Ilton (CB) [V]]

My Lords, I chaired a committee for the Home Office in 1987 on young people, alcohol and crime. Many of the recommendations in this report, ‘It’s Everywhere’ - Alcohol’s Public Face and Private Harm, are similar to those in the 1987 report.

After the report in 1987, I learned that advertising for the alcohol industry is powerful, vigorous and effective. To balance that, it is vital that there should be a forceful, effective education policy to alert everyone, especially the young, to the dangers of unwise drinking. I had two goddaughters who died of alcohol harm, and my mother-in-law, who was an alcoholic, also died early. I spent many years working with young offenders and alcohol was one of the problems involved their lives. Alcohol causes so much violence and family stress.

Recently, university students have died after rugby initiation drinking games. It appeared that they did not know of the dangers associated with drinking large amounts of alcohol over a short period of time. There should be far more forceful warnings about the dangers of excessive alcohol consumption across the country if we want to save lives. I thank my noble friend Lady Finlay of Llandaff for this report and I hope that the Government respond positively.

Crohn’s Disease and Ulcerative Colitis

Baroness Masham of Ilton Excerpts

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is entirely right that diagnosis is key to the accurate and prompt treatment of IBD and associated conditions. That is why we have put diagnosis at the heart of our research programme. Between 2015 and 2020, we funded 20 research projects, many of them on diagnosis, with over £17 million committed. That includes a study into the overlap of IBD and magnetic resonance enterology to image Crohn’s disease patients. This approach is extremely promising.

[Baroness Masham of Ilton (CB) [V]]

Does the Minister agree that some people are hesitant to go to their GP about problems with their bowels as they are embarrassed? Can there be a campaign across the country saying, “Early diagnosis can be vital”?

[Lord Bethell (Con)]

My Lords, I agree with the noble Baroness. A lot of late diagnoses are caused by the kind of delicacy the noble Baroness refers to. My noble friend talked about the challenge of diagnosis, which is made more complex by patients finding a lot of these subjects extremely delicate. The approach taken in primary care to handling such delicate issues has improved dramatically over the years. We are working with GPs and clinicians to make their bedside manner more delicate, so that they are able to broach such delicate issues more sensitively. That, I believe, is at the heart of the problem.

Independent Medicines and Medical Devices Safety Review: Sodium Valproate

Baroness Masham of Ilton Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

As my noble friend rightly acknowledges, the everyday workings of the commissioner require some work. That work is being finalised and regulations will be made setting out further details about the appointment and operation of the commissioner—for example, the terms of office, the finances and other support for the commissioner. Officials are now working with legal and appointment colleagues to firm up time- lines and begin both the regulations and the appointment process for the commissioner.

[Baroness Masham of Ilton (CB) [V]]

My Lords, is the Minister aware that, when his noble friend Lord O’Shaughnessy was the Minister, the noble Lord realised the harm that some women had suffered from taking sodium valproate when pregnant? The noble Lord’s support has been inspirational and has given hope to these victims. Will the noble Lord, Lord Bethell, in his position as Minister now, bring forward a much-needed redress scheme for these women and children who have been let down?

[Lord Bethell (Con)]

I am grateful to the noble Baroness for her tribute to my noble friend Lord O’Shaughnessy, who has done an enormous service to us all by championing this cause, both as a Minister, when he moved this review and made a huge impact, and since then with his patient and thoughtful advocacy of this important cause. He speaks very movingly and thoughtfully, and we are greatly influenced by his persuasion on this subject. The noble Baroness should be reassured that we are absolutely looking at the recommendations for a redress agency, and we will come back with considered thoughts on it when we answer the review in the round. Until then, I welcome all thoughts and advocacy on the subject.