Medicines and Medical Devices Bill

Debate between Lord O'Shaughnessy and Lord Patel

3rd reading & 3rd reading (Hansard) & 3rd reading (Hansard): House of Lords
Thursday 21st January 2021 Lords Chamber

[Lord Patel (CB) [V]]

My Lords, I am delighted to have this opportunity to express my thanks to the Minister—the noble Lord, Lord Bethell—the noble Baroness, Lady Penn, and all the other noble Lords who have been taking part in this legislation, in particular those who spoke to and supported my amendments from all sides of the House.

Much has already been said about what we have achieved. I know that time is running short, so I will try and be brief. Of course I congratulate, first and foremost, the noble Baroness, Lady Cumberlege, for achieving what I had tried before—getting patient safety on statute. I did not have her tenacity or clout. So, many congratulations to her and, I believe, the commissioner for patient safety, who will make patient safety stronger in the whole of the health service.

I am very grateful to the Minister, the noble Lord, Lord Bethell, to the noble Baroness, Lady Penn, and to the noble Earl, Lord Howe, for the many meetings they arranged with us to hear our concerns and find solutions. I know it is a privilege for me to speak in person, but I hope all my colleagues on the Cross Benches—more than 12 of them—who took part in the Bill will feel I can speak on their behalf to thank Ministers and all other noble Lords.

I am also grateful to members of the Bill team, who were very helpful at the many meetings that the Minister arranged. And I am grateful to outsiders, in particular the University of Birmingham faculty of law, which worked very hard to produce the details of the legislation. Thank you all.

[Lord O’Shaughnessy (Con) [V]]

My Lords, there is not much more to say that has not already been said by other noble Lords. I just wanted to use this opportunity to thank and pay tribute to particular groups. The Bill team and private office, which have worked so hard to produce this legislation, are amazing in what they do and often unsung. It is important we recognise them.

Secondly, I thank those patients and patient groups who have provided so much moving information and testimony that has informed our work. After all, we serve them, and I hope and believe that we have served them through improving this Bill in this House in the way we have.

Thirdly, I pay particular tribute to my noble friend Lady Cumberlege. When I was in government and we commissioned her report, I could not have dreamed that she would have done such a thorough job and carried it with her customary tenacity, to the point where we have, on statute, the commitment to a patient safety commissioner. It is such an important step forward and it will make a massive difference to the lives of hundreds of thousands of people in this country. For that, we should all be proud of this step—and she in particular should be.

Finally, I thank the Minister—my noble friend Lord Bethell—the noble Baroness, Lady Penn, and the noble Earl, Lord Howe, but particularly the Minister; he has performed with absolute aplomb in the difficult 10 months since he became a Minister. He has so much on his plate, yet throughout this process he has listened, engaged and acted in a way that does him enormous credit, and I really want to pay tribute to him for everything he has done.

I share the Minister’s optimism that, having produced this Bill, we can produce a regulatory system for the UK outside Europe that is the envy of the world, that makes sure that every company, every charity and every researcher who wants to bring a transformative therapy into a health system will come to us because of what we are able to do and how we are able to bring them through into mainstream treatment, just as we are doing with vaccines and have done with the recovery trial. That is the template, and I look forward to working with my noble friends and other noble Lords to make that happen in the months to come.

Health: Pancreatic Cancer Treatment

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 19th December 2018 Lords Chamber

[Lord Patel (CB)]

My Lords, the Birmingham service has shown that a one-stop clinic for diagnosis and treatment for pancreatic cancer has improved survival rates. Does the Minister agree that our long-term ambition over the next five years should be to develop one-stop clinics and immediate treatment for all cancers, if we are to improve our cancer outcomes?

[Lord O'Shaughnessy]

The noble Lord makes a very powerful case. Indeed, I believe that is the precise model for the rapid diagnostic centres, which are multidisciplinary and not disease specific. They are looking for often vague and hard-to-find signs and developing expertise in that. In October, the Prime Minister announced that is precisely what will be rolled out nationwide.

Sexual Health Services

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 29th November 2018 Lords Chamber

[Lord O’Shaughnessy]

I am grateful to the noble Lord for raising this important issue. First, it is worth saying that the public health grant to local authorities is ring-fenced, and that is meant to provide for sexual health services among others. He mentions STI rates and says attendances have increased. I know that service configurations are happening and there are changes in different parts of the country. It is important that attendances have increased. I think there is a mixed picture on ST infections; some are increasing but there is good news. The noble Lord mentioned teen pregnancy—not that that is a sexually transmitted disease, of course—the rates of which are down. HIV diagnoses are down and we see a positive picture in the new data today, so there is cause for optimism. As we look to the future in the spending review, we will be making the case for improved services at sexual health clinics through the public health spend.

[Lord Patel (CB)]

My Lords, what impact will the closure of sexual health services on the one hand and the reduction in the capacity of other services on the other have on the prevention strategy for HIV in particular and the PrEP trial?

[Lord O’Shaughnessy]

As I have just said to the noble Lord, Lord Cashman, we are seeing a change in services. More services are going online, for example. An e-service for sexual health was launched in January 2018, with 20,000 kits being distributed. So there is a change in the health services being provided. I can tell the noble Lord that there has been no impact on the PrEP trial; indeed, we have already recruited nearly 10,000 of the 13,000 people to that trial, and we are hoping it will be successful.

Government Vision on Prevention

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 6th November 2018 Lords Chamber

[Lord O'Shaughnessy]

I absolutely agree with the noble Lord about ethics. In a sense, everything that we do in this area has to pass the basic fairness test that people apply to it: is this a fair use of resources and a fair distribution of benefit? A number of programmes have been set up to support our work in this area. There is the Centre for Data Ethics and Innovation set up within DCMS. I also point the noble Lord to the code of conduct for data-driven technologies in health and care that I published at the NHS Expo in September. This is our first attempt to provide some rules of engagement on how NHS trusts or other bodies can enter into relationships with technology companies in a way which brings the maximum possible benefits to the NHS. We will do more on this in due course.

[Lord Patel (CB)]

My Lords, I support what the Minister said about the importance of the national data guardian legislation. That will give the public the confidence they need that their health data will be properly used and protected. I hope that legislation will not be held back.

On the Statement, one of the factions of our society that is at higher risk of diabetes and obesity is the south Asian population. I declare my interest as a patron of the South Asian Health Foundation. Any health education programme needs to target that population in order to reduce the incidence of diabetes, which probably runs at around 40% of the population. If we are to benefit from the information that genomics will provide, we need not just bioinformatics but data scientists, with the ability to mine genomics data. My question for the Minister is: what is the plan for further education for both bioinformatics and data science?

[Lord O'Shaughnessy]

I am very grateful to the noble Lord for welcoming the NDG legislation, as he did when we dealt with it in this House. I hope that that can progress at full speed.

On the noble Lord’s point about diabetes, he is absolutely right that prevalence differs from population to population. I will send him details of the NHS Test Beds programme, which includes quite a few diabetes programmes aimed at different parts of the country, which obviously have different ethnic make-ups. We are conscious of the need to tailor messages to particular groups.

The noble Lord is also absolutely right about the workforce. That is why I mentioned the Topol review. It is critical to making sure that people who are in the service are retrained properly, and that we have enough data scientists, bioinformaticians and others.

I apologise to the noble Lord, Lord Scriven; I did not answer his second question about the sunk costs of hospitals. We are in the process of moving to a system of integrated care services, which is an attempt to integrate primary, secondary and tertiary care—we know what the goal is. These things are up and running and are showing some great benefits through the new models of care programme in moving care out of hospital, improving outcomes and reducing costs. That is clearly something that we need to take nationwide.

Antimicrobial Resistance

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 25th October 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Baroness is quite right about the risk in London. We actually have a good TB story in this country—a 41% reduction between 2011 and 2016—but London has the highest rates in the UK. I can tell her that Public Health England and the GLA are working closely together to reduce TB. In fact there are innovative new approaches, such as UCLH’s Find & Treat mobile unit, which I myself visited last year, which is going out and finding people at the highest risk, screening them and then taking them for treatment.

[Lord Patel (CB)]

My Lords, accepting that the overprescribing or inappropriate prescribing of any drug is a bad idea, the issue of bacterial infections will remain with us. I hope the new strategy that the Minister mentioned will address the issue of how we might tackle bacterial infections in future. This could be by developing new antibiotics; developing drugs that deal with infections but do not produce resistance; developing therapies such as boosting the immune response to be able to cope with these infections; and even, if I may say so, developing drugs that might deal with so-called zombie cells that cause infections, which would be more appropriate for older people. I therefore hope his new strategy will address the necessary research.

[Lord O’Shaughnessy]

I can reassure the noble Lord on that front. We have made good progress in dealing with hospital-acquired infections such as MRSA and C. difficile, although unfortunately we have had less success with E. coli. Obviously, a big part of this is driving down infections completely. The other part is about drug discovery, and that is a big global action. It is part of the G20 work that we are taking forward with Argentina to ensure that we have new classes of antibiotics to deal with these problems.

Health: Flu Vaccines

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 23rd October 2018 Lords Chamber

[Lord O'Shaughnessy]

First, take-up was actually at its highest level ever last year. The issue was the effectiveness of the vaccine, which is why the committee’s recommendation was to move to this new vaccine. In terms of confusion about who can get the flu jab, it is clear that we have the most comprehensive flu vaccination programme in Europe. Anybody who has gone to a GP’s surgery or pharmacy and has not been able to access it up to now will—or should—have been told when they can come back and when new supplies will be available. As I said, it is about making sure that can happen before the end of November. We had a fantastic take-up among NHS staff this year; the jab is freely available to NHS staff, social care staff and, for the first time this year, hospice staff.

[Lord Patel (CB)]

My Lords, the reason why the vaccine last year was not as effective was that in the majority of older people, the immune response was poor. The enhanced vaccination, although effective for only three strains of viruses—as opposed to four, before it was enhanced—is better to wait for because it will be more effective in older people. It is the older people that the flu kills so because there is a shortage of supply, Scotland took the view that it will be available only to the over-75s. Does the Minister agree that it is worth waiting for?

[Lord O'Shaughnessy]

I thank the noble Lord for that point but it is important to point out that the over-65s will not have long to wait and that anybody who wants to have it will be able to do so by the end of November, in time for the flu season.

General Practitioners

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 17th October 2018 Lords Chamber

[Lord O'Shaughnessy]

Some people will inevitably travel abroad after their training, but the vast majority of doctors who train in this country stay here. We have more GPs than ever in training. That is obviously the way to solve the long-term challenges of having the right workforce. However, the noble Baroness is absolutely right that we need to recruit from abroad in the short-to-medium term. The NHS has a recruitment target of 2,000 doctors via that route.

[Lord Patel (CB)]

My Lords, one of the key recommendations made in the House of Lords report The Long-term Sustainability of the NHS and Adult Social Care related to training of health professionals. It was based on the evidence that we received of the very thing we are discussing today, which is poor recruitment, not only in general practice but in other areas in healthcare. The key recommendation was that NHS England be asked to review and come forward with a paper that will change the way we train health professionals, so that training is more flexible and integrated and encourages people to go into specialties that are currently in shortage. Does the Minister agree?

[Lord O'Shaughnessy]

I agree with that recommendation. It is certainly being considered as part of the long-term plan, for which workforce is clearly critical. That is one reason why it is significant that there are 3,000 more clinical staff in general practice who are not doctors—nurses, pharmacists and others. Clearly the nature of general practice is changing. Doctors do not have to do everything, and other well-qualified professionals can carry out essential roles.

Health: Contraceptive Services

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 11th October 2018 Lords Chamber

[Lord O’Shaughnessy]

I know the noble Lord is very active on this particular issue. We respect the evidence and are considering what to do about it at the moment.

[Lord Patel (CB)]

My Lords, in response to a request for information, nearly 42% of local authorities reported that they had reduced sexual and reproductive health services because of budget cuts. All the directors of public health in local authorities report that services related to contraception have been reduced because of cuts to the public health budget. There has been a rise in the number of abortions for women around the age of 30 and above and a decrease in the uptake of long-acting reversible contraceptives among women over the age of 30. All this points to the cause being the reduction in the public health budget for local authorities. Evidence-based policy would suggest that that needs to stop or be reversed. I am sure that the Minister will say that he will fix it.

[Lord O’Shaughnessy]

I thank the noble Lord for his question and reiterate the point I made; of course public health budgets have been under pressure and we know why that is. Nevertheless, there are some positive outcomes in the changing of services, such as services moving online, as they have done in London with good effect. It is also worth saying that, in the same survey that the noble Lord referred to, more than 50% of local authorities had either kept the same levels of service or increased them. That is also worth focusing on. Nevertheless, I recognise that there are pressures and that there are behaviours that we do not want to see, such as increasing abortions among the over-30s. We are making the case, and will be doing so in the spending review, for the benefits of public health spending on issues such as this.

General Practitioners: Indemnity Scheme

Debate between Lord O'Shaughnessy and Lord Patel

Monday 16th July 2018 Lords Chamber

[Lord O’Shaughnessy]

I can tell my noble friend that the scheme we are designing is for England, the jurisdiction that the department looks after. However, the Welsh Government have announced their intention to have a state-backed scheme and we are speaking to the devolved Administrations in Scotland and Northern Ireland to make sure that we act together in this regard.

[Lord Patel (CB)]

My Lords, when the scheme is introduced, what plans are there to reduce the level of litigation in primary care, considering that the majority of primary care practitioners are independent contractors, and those who are not are employed by GP principals and not by the National Health Service?

Hepatitis C

Debate between Lord O'Shaughnessy and Lord Patel

Monday 9th July 2018 Lords Chamber

[Lord O'Shaughnessy]

The first thing I would say to the noble Baroness is that, in terms of sexual health clinics, local authorities are mandated to commission comprehensive testing services. Clearly, however, testing needs to happen in many more areas. We have introduced testing in pharmacies, for example, for hepatitis C. That has proved very effective in identifying it in people who take drugs, as well as offering other opportunities to test particularly high-risk communities. Another example is that there has been an increased screening of the south Asian population, where there is a much higher prevalence. It is about using the opportunities of community health services and taking testing into those communities, so that we can deliver on our target.

[Lord Patel (CB)]

My Lords, direct-acting antivirals are the greatest advance that has occurred in trying to eliminate hepatitis C infection—it is effective in 95% of those who carry the infection. So a policy that does not treat everybody who is known to have the hepatitis C virus is wrong. Secondly, if we are to eliminate it, we need to identify those who carry the virus but are not diagnosed. Strategies focusing only on the prison population will not do that. Thirdly, we need to reduce the risk in the at-risk population by educating them. Unless we have a strategy across these three areas, we will not eliminate hepatitis C by 2025.

[Lord O'Shaughnessy]

I agree with the noble Lord that we need a whole-system approach, but I do not think that we necessarily need to condense that into a document. There are lots and lots of things going on, some of which I have talked about. Of course, the WHO target is about the elimination of hepatitis C as a public health risk; it is not about elimination completely. As he said, it is very difficult to find everybody who has not yet been diagnosed. The main thing is that it is reduced as a health risk: it does not kill people anymore and cannot be transmitted. That is what we are on track to do by 2025.

Health: Endoscopy and Bowel Cancer

Debate between Lord O'Shaughnessy and Lord Patel

Monday 2nd July 2018 Lords Chamber

[Lord O'Shaughnessy]

I will have to write to the noble Lord with an answer to his question about the type of endoscopy he mentions, as I do not have the details of it. The risk of false positives is one reason that we have to be extremely careful with screening programmes of all kinds, whether it is the faecal immunochemical test or an endoscopy. As he knows, whatever screening programmes are implemented, the National Screening Committee tries to reduce the number of false positives wherever possible.

[Lord Patel (CB)]

My Lords, given that we have one of the poorest outcomes compared with other health services in the developed world and that the demographic changes that will occur in the population may well mean that one in two people will develop cancer, are the Government aware of what determinants there are for poor outcomes? What plans do they have to improve them for cancer patients?

[Lord O'Shaughnessy]

The noble Lord is quite right to point that out. While outcomes have improved, they lag behind those of other countries, which we need to correct. The independent cancer taskforce set the goal of saving 30,000 extra lives a year by a number of different routes. The one that I pick out in particular is early diagnosis. We know that too many cancers are diagnosed at a late stage, so this year the NHS has committed to increasing the proportion of cancers diagnosed at stage 1 or stage 2, and we are spending £200 million in cancer alliances to support early diagnosis in the community.

Chronic Lymphocytic Leukaemia: Ibrutinib

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 7th June 2018 Lords Chamber

[Lord O'Shaughnessy]

First, I thank my noble friend for the question and for the opportunity to meet sufferers of this illness two weeks ago. As he and the House know, the point of NICE is to provide that expert, objective evaluation of the benefits of drugs both clinically and in terms of value for money. It has clearly made a recommendation in this case. I also know that there is concern about the discrepancy between NICE’s guidance—or, I should say, the summary in section 1 of that guidance—and NHS England’s commissioning guidance, which is narrower. It is precisely that concern about a discrepancy that we are investigating at the moment, and which will be the subject of the meeting that we are having. Once I have more information on that, I shall of course write to him and place a copy of that letter in the Library.

[Lord Patel (CB)]

My Lords, I agree with all the things that the noble Lord, Lord Forsyth of Drumlean, has said. Ibrutinib as a drug was developed after an extensive study to understand the biology of the disease, chronic lymphocytic leukaemia, which increasingly affects older people. Because it was developed following an extensive biological study, it is a targeted drug. In technological terms, it is a tyrosine kinase inhibitor. Therefore, it is more effective in the treatment of this disease and has a better outcome, and some countries have adopted this drug as the first line of treatment. We have used the guidelines that say that the first line of treatment—apart from patients who meet certain criteria, such as those with 17p deletion, who will be given the drug—will be chemotherapy. That then subjects people who have relapsed to a second toxic treatment with chemotherapy, which is wrong. For NHS England to use criteria that are completely arbitrary, except for cost, is also wrong. It should be required to produce the scientific evidence for that, and I hope that the Minister will agree.

[Lord O'Shaughnessy]

I thank the noble Lord for his question. There are two important issues here. First, on this treatment as a first-line treatment, the evidence that was put into NICE by the company itself did not propose its use as a first-line treatment, which is why it has been proposed as a second-line treatment. It is important to distinguish there. However, clearly there is this apparent discrepancy between the NICE guidelines and NHS England. I have, obviously, investigated this, subsequent to the meeting with my noble friend and sufferers. NHS England’s view is that its commissioning guidelines are consistent with the commissioning when the drug was in the cancer drugs fund, and the full NICE guidance, but I also know that that is not satisfactory to some of the patients suffering from this illness who have been in remission for three years. That is precisely what I want to get to the bottom of next week.

NHS: Cybersecurity

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 2nd May 2018 Lords Chamber

[Lord O'Shaughnessy]

My noble friend makes an excellent point. Not only is it critical that data is joined up for direct care—quite rightly, patients are amazed when that does not happen—it is an absolutely essential resource for research into new treatments. One thing we are doing to try to provide that reassurance to the public, which has not always been there, is introducing a new data opt-out at the end of this month to provide that reassurance for patients who do not want to be part of it. We are focused on providing that resilience and security so that they can be confident that, when the NHS holds their data, it uses it securely, safely and legally.

[Lord Patel (CB)]

My Lords, one of the lessons learned following the WannaCry attack was that the weakest links in the NHS had to be identified. The Minister has already referred to the upgrading of software that was found to be weak. What work is being done to identify other areas in the NHS that would be open to cyberattacks?

[Lord O'Shaughnessy]

The noble Lord makes an excellent point. One thing we are now doing is more intelligence-led penetration testing based on work that the Bank of England does, which is to probe in a safe way any weaknesses and to make sure that they are dealt with. The CQC has also added data security to its well-led criteria for inspections. We have now demanded that a board member of each trust takes responsibility for cybersecurity. Indeed, for a trust to be rated as well led, it has to demonstrate that competence.

Health: Online Services

Debate between Lord O'Shaughnessy and Lord Patel

Monday 23rd April 2018 Lords Chamber

[Lord O’Shaughnessy]

I would have to look at the specific clinics that the noble Lord is talking about. The subject of the report was those providing online services. One of the things it discovered was that certain regulatory issues are unique to the provision of online services, an example of which is when the data is held offshore and what that means for regulation. As the CQC says in its report, it is reviewing its regulations to make sure that it can account for the unique aspects of online provision, so that the critical aspects, whether they are about truthful advertising or other aspects, are dealt with properly.

[Lord Patel (CB)]

My Lords, as the noble Lord is aware, there is an increasing number of independent primary care practitioners. What assessment have the Government made of the impact of that on the medical workforce of the NHS?

[Lord O’Shaughnessy]

I am not specifically aware of such an evaluation, but I know that there is a need for more general practitioners, which we are all aware of, and indeed for a plan to recruit many more to the service to ensure that all patients and citizens of this country can find a GP in the NHS when they need it.

Children and Young People: Mental Health

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 28th March 2018 Lords Chamber

[Lord O'Shaughnessy]

That is an excellent question. A terrifying statistic is that 8,000 of those under 10 years old are suffering from severe depression. The designated leaders will be in every school; that is the ambition. We are also rolling out mental health support teams to support all schools, both primary and secondary, so I can reassure the noble Baroness that primary schools are within the scope of the plans.

[Lord Patel (CB)]

My Lords, following on from the right reverend Prelate’s question, I would like to make a plea. Will the Minister agree that the proposed mental health support team should work with the voluntary sector—particularly the children’s voluntary sector—especially in the area of palliative care, and in children’s hospices, where children are bereaved by the death of their siblings and the incidence of mental health problems is also extremely high?

[Lord O'Shaughnessy]

The noble Lord makes an excellent point, and I will make sure it is fed back into our deliberations.

HPV Vaccinations

Debate between Lord O'Shaughnessy and Lord Patel

Monday 26th March 2018 Lords Chamber

[Lord O'Shaughnessy]

We are beginning a national rollout of the programme for men who have sex with men in terms of the provision, because of course they are not necessarily getting the indirect benefits from the girls’ immunisation programme. I do not have the details of the working relationships with the devolved Administrations, but I shall write to the noble Baroness with details.

[Lord Patel (CB)]

My Lords, I am glad that the Minister said that the committee looking at the benefits of immunisation to boys recognises the wider benefits of immunisation for both boys and girls. However, he did say that it was not convinced about the cost effectiveness. Is that cost effectiveness merely for the cost of the programme if instituted now or the long-term benefits?

[Lord O'Shaughnessy]

The committee has to take a number of considerations into account—the public health benefits, short-term and long-term, and cost effectiveness—just as NICE does when approving medicines. It has to make a judgment about whether the incremental pound spent could be better spent across the entire health system, where, of course, there are many competing demands. But it is up to it to make that decision, and that will inform its final advice.

Nurses: Training

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 7th March 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness has highlighted an important issue, which is the number of nurses in social care. I recognise that to be a problem, as does the department. A specific social care workforce consultation will get under way and is linked to the overall draft workforce plan that Health Education England has published. This is something that we are looking at. We can solve it to some extent by increasing the overall number of nurses, but we need to find ways of attracting them into the social care profession.

[Lord Patel (CB)]

My Lords, does the Minister agree that the lack of NHS nurses and other healthcare workers is due to the lack of a long-term sustainable workforce plan, as identified by the House of Lords committee report? If, following that report, the Government now have a long-term workforce plan for the NHS, when might it be published?

[Lord O'Shaughnessy]

I congratulate the noble Lord on his committee’s work in this area and on making a proposal, which we have followed in putting forward a 10-year draft plan. I hope that he will have had the chance to see that—it will of course firm into a concrete plan. It is fair to say that it is honest about both the successes and the challenges that we face in needing to train more nurses. We are trying to find new ways of doing that, not just through the university route but through apprenticeships.

General Practitioners: Workforce

Debate between Lord O'Shaughnessy and Lord Patel

Monday 5th March 2018 Lords Chamber

[Lord O'Shaughnessy]

My noble friend is quite right—there has been anecdotal evidence that that is the case. Of course, any policy changes are well above my pay grade, but I should point out that that does not seem to have affected early retirement among dentists and consultants, so it is possible that another critical factor is at work.

[Lord Patel (CB)]

My Lords, it is suggested that part of the reason for the failure of junior doctors to be recruited as GPs is the nature of GP contracts, which treat them as independent contractors. I know that several are now employed as salaried doctors, but do we have figures for how many salaried GPs, as opposed to principal general practitioners, are employed by the NHS?

[Lord O'Shaughnessy]

That is an evolving model, as the noble Lord has pointed out, and I will write to him with the exact figures. The partnership model has an enduring popularity and importance, which is why the Secretary of State has asked for a review of it. However, as we see new models of care develop, I am sure that salaried GPs will become more of a feature of the system.

NHS: Waiting Lists

Debate between Lord O'Shaughnessy and Lord Patel

Monday 26th February 2018 Lords Chamber

[Lord O'Shaughnessy]

It is absolutely our goal and obligation to return to the referral-to-treatment standard. It is worth pointing out that the NHS has been dealing with an annual growth in demand of around 4%, which is extraordinary when looked at historically. What we have seen in the plan set out a few weeks ago are important steps to get a grip on that, including halving the number of 52-week waits, halting the growth in the waiting list and delivering more every year. Clearly that is an interim step and more needs to be done; the way to achieve that is by continuing to provide real-terms increases, which we have done and will continue to do, and by dramatically increasing the number of staff in the NHS, which again we have done. We have also increased the number of training places.

[Lord Patel (CB)]

My Lords, does the Minister agree that imposing a mandatory time of up to 16 weeks for elective surgery, as it has recently been reported that many clinical commissioning groups are doing, is wrong, and that how long a patient should wait for elective surgery needs to be a clinical decision?

[Lord O'Shaughnessy]

The length of time to wait should always be a clinical decision; I completely endorse that. CCGs have responsibility to manage demand according to local needs, but in the end, it must be a clinical decision.

Disabled People: Social Care

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 20th February 2018 Lords Chamber

[Lord O'Shaughnessy]

I do not want to disappoint the noble Baroness, but she is aware that more money is going in. To address the specific issue that she talks about—and I obviously can talk about it only from the point of view of the Department of Health—we want and are seeing more disabled people going into work. I would point to one big investment that the Department of Health is making, which is the disabled facilities grant. That is about making sure that disabled people can live at home and have their independence, which of course is critical to maintaining their physical health and confidence to make them, in a way, ready to go into work. I know that there are other programmes being put through job centres and the Department for Work and Pensions to make sure that they are supported, too.

[Lord Patel (CB)]

My Lords, I take this opportunity to thank the Minister for laying before Parliament today the government response, 11 months after the report was produced, to the House of Lords Select Committee report on the long-term sustainability of the NHS. We will now get an opportunity to debate the report and the Government’s response in due course. One recommendation that was accepted was the renaming of the Department of Health as the Department of Health and Social Care. Attached to that was the recommendation that the budgets should be amalgamated so that we can provide social care to all those who need it—both care for the disabled and adult social care. Would he like to comment on that?

[Lord O'Shaughnessy]

I am glad to be able to publish the response at last, and apologise again for how long it has taken. I am pleased to report that we have not just changed the name of the department but given the strategic direction for social care policy back to it. That also includes strategic direction of funding—but the actual funding settlement happens through the local government funding settlement. I have to disappoint the noble Lord on that because there are no current plans to change it.

Health: Pelvic Mesh Implants

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 6th February 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Baroness is quite right to say that it is not just about having the guidelines but making sure that clinicians follow them. Professional standards demand that clinicians do follow them, and indeed a clinician would need to be strongly justified in using mesh implants outside of the guidelines. They include things like gaining consent, providing information and registering operations that have been carried out. The guidelines are very strict and we expect clinicians to follow them.

[Lord Patel (CB)]

My Lords, does the noble Lord agree that, while we cannot be sure why New Zealand and Australia have suddenly announced total bans on the use of mesh implants, the evidence suggests that of the 20% of women who suffer from complications, most of them had been treated for pelvic floor prolapse, not stress incontinence? Banning their use completely at this stage for women with certain conditions who may benefit from them would, without further evidence, be completely wrong.

[Lord O’Shaughnessy]

The noble Lord speaks with great experience. Obviously, a number of procedures are involved, and NICE is now looking at extra procedures to provide the guidance. It does look like it is not the right thing to do in cases of prolapse, but it can be a very successful course of treatment for other conditions. It is important to take a differentiated approach.

NHS: Clinical Negligence

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 31st January 2018 Lords Chamber

[Lord O'Shaughnessy]

We absolutely have. Indeed, the PAC investigation and the National Audit Office report on this issue are very thorough and looked at the causes and drivers behind it. One is increased NHS activity—not worse safety but the fact that the NHS is doing more. The investigation also looked at the legal environment and some of the changes that have occurred. The noble Baroness is right: a number of firms offer these services. That is important for access to justice but we also need to fix the costs that they can claim so that we get this budget under control.

[Lord Patel (CB)]

My Lords, the statistics show that 46% of the litigation cases involve misdiagnosis and 34% involve surgical errors. However, the largest settlements are for obstetric cases, particularly those related to babies who have suffered brain damage at birth. The important thing is to prevent these accidents occurring. The key issue here is better and continuous training in interpreting foetal heartrate patterns during labour. That is what we should focus on—preventing these cases happening.

[Lord O'Shaughnessy]

I completely agree with the noble Lord and make two points in response. He will know of the Secretary of State’s great passion for this area and of the maternity safety training funding and other training funding. From April, we will introduce the healthcare safety investigation branch, which will investigate each of the 1,000 incidents noted by the Each Baby Counts project which occur at birth, whether brain damage or neonatal death, precisely so that we can learn from that experience and make sure that those who provide these services are properly trained to avoid these incidents wherever humanly possible.

NHS: Nurse Retention

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 17th January 2018 Lords Chamber

[Lord O’Shaughnessy]

On the specific and most recent workforce data—if we are going to get into the specifics of nurses only—in May 2010 there were 273,071 nurses and in September 2017 there were 275,356, so that is an increase. I shall certainly look into the figures with which I wrote to the noble Lord. Of course, I intend always to be truthful. I am reading from the latest workforce stats.

As for nurses on wards, the noble Lord will know that the number has gone up. An important response to the scandal of Mid Staffordshire and the Francis report was to increase nurse numbers. We know that that has a consequence for other professions—I have talked about that quite openly—and in mental health and district nursing. That is why we want to increase the number of nurses in those areas.

[Lord Patel (CB)]

Does the Minister agree that the real issue is the lack of long-term workforce planning of all health professions, including social care? That planning should address the changing demography of citizens and the changing pattern of disease—and involve flexible training. Does he agree that that is what is required, and that what we have now is too many individuals or organisations trying to address the workforce? While he is at it, could the Minister also put on record when the Government will respond to the Select Committee of this House’s report on NHS long-term sustainability, which was published 10 months ago?

[Lord O’Shaughnessy]

The noble Lord speaks with great wisdom and experience. He is quite right about the need for long-term workforce planning. I hope that is why he will welcome the 10-year strategy that Health Education England is launching. It is looking at diversifying the working population—for example, through the growth in the number of nursing associate training places.

On the report, I can only apologise again for the delay. I hope that at least the noble Lord will welcome the fact that in the reshuffle the health department gained social care policy. That was one of the issues on which he wanted to promote greater integration.

Health: Atrial Fibrillation and Stroke

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 12th December 2017 Lords Chamber

[Lord O’Shaughnessy]

On the stroke strategy, a follow-on plan is being developed by NHS England and its partners, including the Stroke Association, which will take forward that approach. The noble Lord will also be pleased to know that it is an integrated-service approach including ambulances, community care and secondary care. On the point about reorganisation, he is quite right that London has seen excellent success through the specialisation and concentration of services, and we certainly encourage the rest of the country to do that too.

[Lord Patel (CB)]

My Lords, during the House of Lords Select Committee inquiry on the long-term sustainability of the NHS we heard a great deal of evidence demonstrating the great variations in care, in the treatment not only of atrial fibrillation but of other conditions. Is it not time that we made the NICE guidelines, which are very clear about the management of patients with atrial fibrillation, mandatory to reduce the variation in care and improve outcomes?

[Lord O’Shaughnessy]

As the noble Lord will know better than anyone, making them mandatory is a challenge because of the importance of clinical autonomy. What we can make mandatory is an understanding of those guidelines and that they inform every treatment pathway. That is part of what the NHS RightCare programme, which is now rolled out across the country, is doing. It is introducing new things such as stroke pathways so that there is clarity about the options available. Patient choice is at the centre of that decision.

HIV Prevention Services: Public Health Funding

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 30th November 2017 Lords Chamber

[Lord O'Shaughnessy]

I quite agree with the noble Baroness. As I said, across England about 12% or 13% of gay and bisexual men and other men who have sex with men are undiagnosed. That is clearly unacceptable and means we are still not yet meeting the UNAIDS target. I will point out a couple of the interventions happening to try to address that in addition to the ones that I have already mentioned. A new contract has been awarded by Public Health England to the national HIV prevention programme for the most at-risk populations precisely to try to reach them. Another £600,000 is being given to 12 schemes under the HIV innovation fund. By definition, the people we need to reach next are the most difficult to reach because they have not come into the system.

[Lord Patel (CB)]

My Lords, as PrEP is clearly scientifically assessed through meta-analysis to be the most effective treatment for reducing incidence of HIV for the at-risk population, will the Minister say how widely this treatment is available for the at-risk population through the NHS?

Maternal Safety Strategy

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 28th November 2017 Lords Chamber

[Lord Patel (CB)]

My Lords, credit where credit is due: I commend the Government for this initiative. It was first suggested some years ago but that does not matter; it is here now. My question relates to the root cause analysis, which is rightly the way to analyse stillbirths that occur. It should take account of all the circumstances, including staffing levels, as mentioned. It is not just about the care itself. Can the Minister clarify how the system of doing root cause analysis of every stillbirth will work if, at the same time, a coroner is doing an investigation?

[Lord O’Shaughnessy]

I thank the noble Lord for his support for today’s announcements. Obviously, independent investigations are just that. They will be operated by HSIB, which will be able to delve into the causes of the tragedy, however it might have happened, and provide an opinion on that. On the interaction with the coroner’s report, obviously we have focused mainly today on these new independent investigations and we are looking at extending coronial law to take in stillbirths that were previously not included. That is one of the issues that needs to be worked out in the coming months through interaction with the Ministry of Justice.

NHS: Deficit

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 22nd November 2017 Lords Chamber

[Lord O’Shaughnessy]

My noble friend is absolutely right: there are no barriers. Indeed, the five-year forward view, in which the NHS sets out its own future, talks about integration and moving towards accountable care systems. Some capital programmes have been announced today under what will amount to a £10 billion capital programme over five years. These are precisely to deliver the transformation which is needed by making the kind of investment to provide that level of integration.

[Lord Patel (CB)]

My Lords, the Minister has said previously that he read the cross-party House of Lords report on the long-term sustainability of the NHS and adult social care with enthusiasm. No doubt he will have noticed several recommendations in it that would go a long way towards making the NHS financially stable and sustainable over the long term. Does he agree that what is now enthusiastically required from him and from the Government is to accept those recommendations? A short answer made up of a three-letter word will suffice.

[Lord O’Shaughnessy]

The noble Lord waits patiently. I pay tribute to the quality of the report and we have already accepted some of the ideas set out in it. Now that the Budget is over and the Treasury can turn its mind to additional things, we will be responding to the report very soon.

National Health Service

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 10th October 2017 Lords Chamber

[Lord O'Shaughnessy]

I know that the noble Lord has been concerned about this issue. I hope that he heard my right honourable friend the Secretary of State announce last week not only an increase in the number of nursing associate places, where qualification is through an apprenticeship route, but a 25% increase in the number of degree training places and funding for the clinical placements that they involve.

[Lord Patel (CB)]

Can the Minister say whether he found helpful the House of Lords Select Committee report on the long-term sustainability of the NHS and social care?

[Lord O'Shaughnessy]

The noble Lord knows that I found it extremely helpful. It has pride of place on the coffee table in my office, and we will of course respond to it in due course.

NHS: Shared Business Services

Debate between Lord O'Shaughnessy and Lord Patel

Tuesday 27th June 2017 Lords Chamber

[Lord O'Shaughnessy]

Clearly, if there were such an incidence, the noble Lord is quite right that it would be dealt with very strongly—but it is important to point out that there has not been evidence that that has happened. Documents were destroyed that sat within SBS, but they were not part of the backlog and they conformed, as we understand it, to the protocols around destroying old papers when they have gone past a certain time limit. So there is no evidence that what the noble Lord described has happened in this instance—but, as he points out, if it had happened it would be of the utmost seriousness.

[Lord Patel (CB)]

My Lords, what is the governance mechanism of this joint private venture? Considering that one of the key tasks is to deliver letters and patient reports in a timely manner to GPs’ surgeries, what risk assessment was made during the process of the work?

[Lord O'Shaughnessy]

Yes, this specific case was a joint venture between a private company and the Department of Health, which has a share and director places on the board. The department had a director on the board of this joint venture throughout. Part of the problem was that the issue of this unacceptable practice was not brought to the attention of the board until far too late in the process. That is obvious from the timeline that has been set out. The particular issue about redirection is no longer the case. Mail is now returned to sender if it is not delivered, rather than creating opportunities for the things going wrong that happened through this redirection service.

NHS and Adult Social Care

Debate between Lord O'Shaughnessy and Lord Patel

Wednesday 5th April 2017 Lords Chamber

[Lord Patel]

To ask Her Majesty’s Government what is their assessment of the long-term sustainability of the National Health Service and adult social care.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, the NHS and adult social care systems face unprecedented challenges due to an ageing, growing population and rising expectations. Making these systems sustainable for the long term depends on changing the way that services are delivered, with much greater emphasis on integration and keeping people well and independent for longer, as set out in the NHS Five Year Forward View and delivery plan.

[Lord Patel (CB)]

I was hoping that the Minister might thank us for the brilliant and well-written report published today. It is, following a great deal of difficulty, a consensus report from all sides of this House, including the Spiritual Benches, and I hope that it will be met with political consensus when the politicians have had time to digest it. It has identified some key threats to the long-term sustainability of health and social care, and I shall allude to just one of them: if we do not get a long-term settlement for social care funding, healthcare will continue to suffer. The report makes some good suggestions, including how individuals who can afford it can make a contribution to funding the long-term sustainability of social care. I hope that the Minister will take that on board when he devises the Green Paper on social care.

[Lord O'Shaughnessy]

I thank the noble Lord for that. I did not want to get ahead of myself but I thank him and all members of the committee for their work in putting together this document. I appreciate that it is an incredibly thorough and important piece of work, and I am also grateful to have received an embargoed copy of it yesterday. I will of course look carefully at all the recommendations and respond properly in due course. I am sure that we will also have an opportunity for a longer debate.

The noble Lord specifically asked about social care, and I completely agree with the priority attached to it in the report. He will know that the Government have committed more money in the short term to support social care, with £2 billion more having been announced at the Budget. But I know that his emphasis and the emphasis of his committee was on long-term reform. He is quite right to point out that the Green Paper is a very important opportunity to take a broad perspective and to put the system on a sustainable long-term footing.

Gene Editing: Agriculture and Medicine

Debate between Lord O'Shaughnessy and Lord Patel

Monday 27th March 2017 Lords Chamber

[Lord Patel (CB)]

My Lords, I would like to take the discussion about regulation further. The question that the noble Lord, Lord Winston, just asked emphasises that we need a regulation in place now that is balanced, so that we can allow the researchers to progress further, including if necessary to demonstrate why germline gene editing may be necessary but should not be allowed. We lead the world in immune gene editing, as shown in the example of Layla, a one year-old girl who was treated for acute megaloblastic leukaemia, which was the first such case in the world. Does the Minister think it right to ask the appropriate departments in those agencies to produce something now on the regulation of gene editing that would be appropriate for Parliament to discuss?

[Lord O’Shaughnessy]

My noble friend is right to highlight the potential of gene editing by referring to that life-saving treatment of a girl with leukaemia. We have a world-leading regulatory climate and there are strict rules governing research in this area: for example, research involving the use of embryos is allowed up until 14 days but not beyond. We should certainly carry on with that research—indeed, we have a more permissive regulatory environment than in much of the world. As my noble friend rightly points out, we need to do that with the purpose of respecting life and of course reducing harm, driven by the desire to do so.

Tobacco Control Plan

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 23rd February 2017 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord makes an extremely important point. There are big variations in levels of smoking, not just by socioeconomic group. I was disturbed to see that 37% of people with mental health conditions smoke, which is twice the overall prevalence. We also know that there is a huge variation in the number of women who smoke when pregnant. Targeting that variation, which has a number of dimensions, will be a core part of the strategy.

[Lord Patel (CB)]

My Lords, there are 4,500 admissions to hospitals per day of people suffering from smoking-related diseases, and over 80,000 people per year die from such diseases. I know the Government have stated their plan for a policy that will reduce this harm. In that context, does the Minister think there might be lessons for us to learn from Finland’s plan to be tobacco-free?

[Lord O’Shaughnessy]

I will certainly look at what they are doing in Finland. I was not aware of that, and it is a very ambitious goal. As a former smoker, I have to say I know the benefits both in health terms and in my pocket from reducing smoking. It is essential that we continue on the trajectory of reducing smoking that has been going for a long time. England is a world leader in this area, and we should recognise that. There has been huge success but clearly there is a lot more to do.

Health Service Medical Supplies (Costs) Bill

Debate between Lord O'Shaughnessy and Lord Patel

Report stage (Hansard): House of Lords
Tuesday 7th February 2017 Lords Chamber

[Lord Patel (CB)]

My Lords, I support this amendment, to which I have added my name. I do not agree with the noble Lord, Lord Lansley, that the second part of the amendment is not crucial. I take a completely opposite view. I consider that that is the crucial part of the amendment. The proposed new paragraph (b) refers to the need to,

“ensure that patients have rapid clinical access to new clinically effective and cost-effective medicines and treatments approved by the National Institute for Health and Care Excellence through their technology appraisal process”.

The terms “clinically effective” and “cost-effective” are important. I would insert the word “thorough” so that the amendment reads “thorough technology appraisal process”. That is what NICE does. That is what we set it up to do. Parliament agreed that if NICE approved a drug that was cost effective and clinically effective, it should be available to patients. Now we are saying that that should occur only if certain provisions apply, and in certain circumstances they do not. So what are we saying? What message are we sending out if NHS patients cannot get medicines and treatments that are deemed to be clinically effective and cost effective, including drugs and treatments developed by our own scientists and produced by our own life sciences industry? People from our own industry have told me that when the NICE-approved drug is not available in the United Kingdom and we try to market it in other countries, their competitors say, “Why is it not available in your country when you’re trying to persuade us to use it?”. As has been said, many drugs are often available in countries such as Germany, France, Canada, Austria and many others that are not available in the United Kingdom. The noble Lord, Lord Hunt of Kings Heath, mentioned cancer drugs that are not available. Some would say that that leads to the poor cancer outcomes in our country compared with those in some other countries.

Recent proposed changes relate to the budget impact threshold of £20 million over two years. The noble Lord, Lord Lansley, is right that this sword has two sharp edges. Whichever way you tackle it, the patient gets hurt. Around 20% of new treatments with a positive NICE recommendation could have their introduction delayed if we adopt NHS England’s new proposals. For example, about 35,000 patients suffer from secondary or metastatic breast cancer. However, a drug costing £1.56 per patient per day would meet the budget impact threshold of £20 million. It would therefore be delayed for introduction to treat these 35,000 patients. For most of them, their life—quality life—could be prolonged by about six months to a year, but they will be dead before the drug is made available at a cost of £1.56 per patient per day. That is what this proposal of £20 million means. It is a budget impact threshold.

People with rare diseases will fare even worse. There are about 7,000 known rare diseases. Treatment exists for only about 5% of those patients. The British company Shire, for example, has about 30 products in its pipeline to treat rare diseases. But why would it manufacture them at some cost when it might find that it falls foul of the new arrangements even if the new drugs prove effective?

I recognise the economic challenges that the NHS faces. I have heard the 20,000 pages of evidence given to the committee that I chair on your Lordships’ behalf and which we will soon be publishing. We need a system that prepares the United Kingdom to deliver the next generations of innovative medicines, including gene and cell therapy. If we are going to do that, it is important that pharma and the industry have certainty of patient access. That is crucial when companies make decisions on new investments in research and manufacturing.

Regarding proposed new paragraph (a), I would simply say that as we prepare to leave the EU, the delivery of an internationally competitive industrial environment for the bioscience and life science sectors is more important than ever. By making it more difficult for patients to access highly innovative, first-to-market, cost-effective and clinically effective medical products, we not only deny our patients the treatment they need but risk the future of our world-leading life science industry. I am sure we do not want to do that.

The Prime Minister’s industrial strategy, which will invest in science, research and innovation, has already been mentioned. The life science sector—not the pharma industry, which the noble Lord, Lord Warner, mentioned —brings in over £60 billion a year and employs over 220,000 people. British science, with investment in genomics, gene sequences, diagnostics, and now the production of gene and cell therapy, is again investing huge sums of money. To promote this, the Higher Education and Research Bill, which is currently going through your Lordships’ House, creates UK Research and Innovation to do research and innovate therapies, all of it in life science. As to our charity sector, the Wellcome Trust invests probably in the region of £1.3 billion a year in science, which will go to innovation. Cancer Research UK is about to announce four grand challenges. It makes awards of £20 million to find causes and treatments for cancer, and the British Heart Foundation also makes an enormous investment.

Hitherto we have had a pact that operates for the public, the NHS, the scientists and the industry on the availability of medicines and treatments for both diagnosis and treatment, delivered at a cost that is fair, transparent and appropriate. When we break that pact by not making available treatments to patients even though they are cost effective and clinically effective, we are denying treatment to many patients. The fundamental basis of the pact—which Parliament approved when agreeing to how NICE should operate—is that if NICE deems that a medicine is cost effective and clinically effective, patients should get it. That is why I strongly support the amendment.

[Lord O'Shaughnessy]

My Lords, I am grateful for the quality of the debate on this amendment. Before I turn to the specifics of the amendment, I join noble Lords in reflecting on the success of the UK life sciences industry. The UK has a lot to be proud of. We have a world-class science base and an excellent reputation for the quality and rigour of our clinical trials and the data they produce. The UK has one of the strongest life sciences industries in the world, generating turnover of more than £60 billion each year. Indeed, it is our most productive industry. This Government are deeply committed to supporting that industry to flourish and, in doing so, to provide jobs and transform the health of the nation. That is why it was a Conservative-led Government which introduced the first life sciences strategy in 2011.

More recently, we have introduced a range of measures through the taxation system to create good conditions for business growth and to encourage business investment. These include: R&D tax credits for small and medium-sized enterprises; R&D expenditure credit for larger firms; the patent box; a permanent annual investment allowance; and the seed enterprise investment scheme, the enterprise investment scheme and the venture capital trust scheme, as well as entrepreneurs’ relief.

Take just one of those examples: the patent box. Phased in from 2013, under a Conservative-led Government, it incentivises companies to develop and manufacture new, innovative patented products in the UK by giving an effective 10% corporation tax rate on UK profits derived from the product’s qualifying UK and EU patents and equivalent forms of intellectual property. In 2013-14, a total of 700 companies claimed relief under the patent box, with a total value of £342.9 million, with 64% of those in manufacturing. In 2013, GSK decided to invest more than £500 million in the UK after the patent box was announced. Its CEO Sir Andrew Witty said:

“The introduction of the patent box has transformed the way in which we view the UK as a location for new investments”.


The Government’s R&D tax credit is one of the biggest sources of financial support for innovative UK companies and one of the most competitive in the world. It is widely commended and, in 2014-15, almost 21,000 companies claimed tax relief, totalling £2.45 billion, with R&D expenditure used to make these claims reaching £21.8 billion. The Autumn Statement announced £4 billion of additional investment in R&D, specifically targeting industry-academia collaboration, which is so important in the life sciences. We would expect the life sciences industry to be a substantial beneficiary. I am sure your Lordships will agree that these are bold, new, high-value measures which demonstrate that the Government are serious about attracting inwards R&D investment into cutting-edge industries like the life sciences.

This determined action is reaping rewards. The UK ranks top in major European economies for foreign direct investment projects in the life sciences. Just last week, Danish drugs company Novo Nordisk announced a new £115 million investment in a science research centre in Oxford. This comes on top of £275 million additional investment announced by GSK in June and AstraZeneca reaffirming its commitment to a £390 million investment in establishing headquarters and a research centre in Cambridge. As the noble Lord, Lord Patel, mentioned, we are also working on the creation of UK Research and Innovation to enhance this further. These are examples of the positive policy changes that are supporting the life sciences industry and transforming the health of our nation.

Looking ahead, Professor Sir John Bell, whom several noble Lords have mentioned, has agreed to lead the development of a new life sciences strategy for the long-term success of the UK. The formation of the strategy will bring together broad representation from across the sector, including from industry, charities, academia and the health and care system. It is aligned with the industrial strategy announced recently by the Department for Business, Energy and Industrial Strategy. The strategy will outline what the life sciences industry can deliver for the UK economy and for UK patients and set out what actions government needs to take to set the framework on the road to success. Building on a sector deal for this diverse and complex sector, the life sciences strategy will be bold and ambitious as befits the needs of a global Britain. We will seek to make the UK the global home of medical innovation, creating jobs, improving health outcomes and transforming the NHS.

As all noble Lords have mentioned in the debate today, the issue of access to or uptake of new medicines in the NHS must be a key part of that life sciences offer. I recognise and share the desire of noble Lords to ensure that the NHS is at the forefront of innovation, and that medicines which have been approved by NICE are made available quickly to the patients who could benefit from them. This Government have been very active in improving access, and have already taken a number of important steps to do so. The early access to medicines scheme, introduced in 2014, provides a platform for drugs that do not yet have a licence to get to patients at a much faster rate than before. We have now seen 29 promising innovative medicine designations, and 10 positive scientific opinions have been awarded by the MHRA, the regulator. As my noble friend Lord Lansley mentioned—and I must give him credit for the introduction of this policy—the cancer drugs fund, created in 2011 and renewed in 2016, has provided over 95,000 patients with access to innovative cancer drugs that would otherwise not have been available.

Sustainability and Transformation Plans

Debate between Lord O'Shaughnessy and Lord Patel

Thursday 26th January 2017 Lords Chamber

[Lord O'Shaughnessy]

Clinicians and local authorities are involved in these plans. The whole point of the plans is that they bring everybody together within an area to create changes that are driven from the bottom up, so as to provide a much more efficient service. The noble Lord knows full well that more money is going into both primary care and the service overall.

[Lord Patel (CB)]

My Lords, STPs are a major systems change in the way healthcare will be delivered. As the Minister said, there will be significant demand for the resources going into them. What are the governance arrangements for the STPs?

[Lord O'Shaughnessy]

I thank the noble Lord for that question. STPs are voluntary groupings of all the relevant people—whether that is at the acute level, in primary care or local authorities—coming together under leadership to create the changes. Those then turn into operational plans that are delivered by individual hospitals, primary care settings and so on.