Draft Pharmacy (Premises Standards, Information Obligations, etc.) Order 2016

Andrew Gwynne Excerpts

Tuesday 1st March 2016 General Committees

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

It is a pleasure, as always, to serve under your chairmanship, Ms Dorries. I thank the Minister for his useful overview of the effects of the draft order.

No one will disagree with the overall aim of improving standards and practice in the distribution and use of medicines. Medicines are a critical and essential part of the healthcare system in this country, and the accurate dispensing of medicines and the quality of the advice given by pharmacists are of paramount importance.

Overall, the draft order is eminently sensible, but it must be looked at in the context of where community pharmacy is going. Around 1.6 million people visit pharmacies every day. Pharmacies are among the most high-frequency interfaces of the health and social care system, so they have huge potential to fulfil many of people’s most regular requirements of that system and potential to take the strain off accident and emergency departments and GP surgeries. I am therefore a little confused that the Government are pushing ahead with reductions in the community pharmacy budget, which I understand will be the subject of an oral question in the other place tomorrow afternoon.

Ministers themselves estimate that between 1,000 and 3,000 community pharmacies will have no option but to shut their doors. Those closures will mean job losses and worsening pay for people across the sector. Pharmacists are often seen as simply suppliers of medication that others prescribe, but I am sure that the Minister will agree that they are so much more than that. The Opposition worry that this will become a self-fulfilling prophecy. Pharmacists carry out legal and clinical checks, administer vaccinations and emergency contraception, and review the effectiveness of people’s medication. The changes in the sector will be regressive, and I hope that the Minister will reconsider them.

My colleague Lord Hunt of Kings Heath made an excellent point when the draft order was debated in the other place. When the Health and Social Care Bill was debated in 2012, there were discussions about whether community pharmacists could be represented on the boards of clinical commissioning groups. The Government decided against that, but I suspect that because pharmacists are not around the table we often miss their valuable contributions in discussions on various parts of the healthcare system, of which they are usually a crucial part. Lord Hunt was right to say that we are missing a trick here.

We are happy to support the draft order and we note that the responses to the Government’s consultation were overwhelmingly positive, but I have placed on the record the concerns of Her Majesty’s Opposition with the Government’s approach to the pharmacy sector and I hope that the Minister will take those concerns away.

Crohn’s and Colitis Treatment: England

Andrew Gwynne Excerpts

Wednesday 24th February 2016 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Roger. I, too, commend the hon. Member for St Albans (Mrs Main) not only on securing the debate and the eloquent way in which she opened it, but on the work she is doing to help raise awareness of Crohn’s and colitis. Although the debate is about the situation in England, we have had a valuable set of contributions from Members from Wales and Scotland. While it is right that the public health Minister is responsible for this policy area in England, there is a lot of experience and research that we should be sharing. We should also be sharing a lot more understanding of what each part of the NHS in each respective part of the United Kingdom is achieving in the work to try to tackle some of the issues.

I put on record my thanks to Crohn’s and Colitis UK for all its hard work in briefing Members of Parliament for this debate, and for all the work it has done since its inception in 1979. I will let you into a secret, Sir Roger. I am fairly new to the shadow public health role, although I have been on the shadow Health team for some time now. I must confess to not being entirely abreast of the issues facing IBD sufferers before looking at them for this debate. Frankly, what I found stunned me. More than 300,000 people in the UK suffer from Crohn’s or ulcerative colitis, and that equates to some 460 people in my constituency alone.

While that is a lot of people, IBD is not as prevalent as some of the more common long-term conditions. That means that research funding, as we have heard over the course of this debate, is thin on the ground, and there is not the same level of awareness in the general public at large. Put simply, it is not a glamorous cause. There are few outward signs of having the condition, but the effect on lifestyle is massive for the people concerned. Many of the problems that we discuss regularly in terms of cancer are just as pronounced when it comes to IBD, and not only include pain, fatigue, sleep deprivation and disruption to life in general, but also relate to awareness, diagnosis and psychological impact, and I want to touch on those things.

First, I want to address the problems of diagnosis. GPs need to be more aware of IBD. Every medical practitioner knows of instances of general abdominal pain and irregular bowel function being written off as IBS. As I have already said, I was not fully aware of the problem of misdiagnosis until I heard from Crohn’s and Colitis UK, so the matter does come down to awareness both among the general public and, importantly, among the medical community. Because the most pronounced symptoms of IBD are often the most embarrassing to discuss, the issue often gets swept under the carpet, even in the GP’s surgery.

Studies have shown that 35% of people with Crohn’s had three or more emergency admissions before they received a diagnosis. Frankly, that just is not good enough. I accept that some delays to diagnosis are inevitable, considering the nature of the disease, and clinical judgment should receive an appropriate degree of latitude, but we can and we must do much more.

There are some welcome signs. In 2013, NICE recommended faecal calprotectin testing as one option for doctors to help distinguish between IBS and IBD, which is welcome. There can be more effective use of that at primary care level, which would save not only money but would ensure better and more efficient care for patients: an undeniable win-win situation for all involved. How will the public health Minister improve the efficiency of the identification of suspected IBD? We also need to reduce the unnecessary use of endoscopies where less intrusive tests would do just fine.

I want to spend some time talking about the psychological impact, which Members have touched on today. Last year, the Opposition established the post of shadow Mental Health Minister, a job in which my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) is making a significant impact. Mental health is of paramount importance to the Labour party, and it is often the unseen damage that is most destructive. IBD symptoms, diagnostics and treatment can have a disastrous impact on a sufferer’s mental health. The uncertainty and sense of lost potential must be absolutely awful, and I cannot help but imagine how I would feel were one of my children told that they had IBD.

An audit in 2014 found that only 12% of services have a clear process to enable people suffering from IBD to see a psychologist or professional with knowledge of IBD. That figure may have improved—we might see that when the next audit is carried out—but however we look at it, it is not good enough. About 41% of IBD sufferers experience high levels of anxiety, and so of course we must do more, because many people living with IBD feel that simply having easier access to psychiatric services at critical points would help immensely. With the Government’s laudable commitment to ensuring parity of esteem, which we are fully behind, what is the Minister’s Department doing to make sure that people with IBD across England have the appropriate level of access to tailored psychological support with professionals who are familiar with the very specific issues they face?

I am pleased that hon. Members have mentioned the access to toilets strategy formed by my Labour colleagues in Wales. Obviously, an episode of incontinence in public is extremely embarrassing, and with incredibly poor access to public toilets being endemic across England, a person with IBD can feel anxious even being in an unfamiliar place. Many people with IBD have seen a devastating impact on their capacity to lead normal lives when they are away from home. I am therefore pleased that the Welsh Government have led by treating access to public toilets as a public health issue.

The Welsh Assembly is now considering the Public Health (Wales) Bill, which is close to the final stages of the legislative process. Some fairly simple steps can have a big impact on the ability of Crohn’s and colitis sufferers to lead normal lives when out and about. Councils, for example, could make better use of the toilets that are already in the community, whether in public buildings or private businesses. The Bill will place a duty on every council to publish a local toilet strategy. The Welsh Government are leading the way, and I hope the UK Government will follow suit. I appreciate that it might require intervention by the Minister’s colleagues in the Department for Communities and Local Government to halt some of the public toilet closures that we have seen in recent years, but will the Minister offer to discuss this not only with her colleagues in DCLG, but with my Welsh Labour colleague, Mark Drakeford? I think there is plenty of potential here.

My thanks go to all hon. Members for their contributions this afternoon. Some incredibly astute points have been made, and I hope the Minister goes away better informed, as I know I will, as a result of this debate. We owe it to those 300,000 people in the UK suffering from Crohn’s disease or colitis to come up with some better ideas in the coming months and years. This debate has given us a good starting point, such as the need for better public toilet access, and the need for more widespread use of less invasive diagnostic techniques. About 18,000 new cases of IBD are diagnosed every year, so this is not some fringe problem, but an issue facing people in every single community across the country. I look forward to hearing the public health Minister’s response.

Oral Answers to Questions

Andrew Gwynne Excerpts

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

Andrew Gwynne Excerpts

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.

Childhood Obesity Strategy

Andrew Gwynne Excerpts

Thursday 21st January 2016 Commons Chamber

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I congratulate the hon. Member for Totnes (Dr Wollaston) on proposing and securing this important debate, and she will be pleased to hear that I agreed with almost everything she said. Many here in the Chamber will be aware of my strongly held passion to provide all children with a hot and healthy school meal, especially one that is free. The debate around the Government’s impending childhood obesity strategy, both here in Parliament and in the outside world, has focused on the reformulation of foods that are high in sugar and salt and the introduction of a sugar tax. Although I support those measures, I want quickly to discuss how school food can play a significant role in addressing the obesity crisis facing our children today.

I want to say at the outset—I am sure people are thinking this, if not here then definitely on social media—that I am rather overweight myself and that some may say I should practise what I preach. I do try. But that is why I am so passionate about this agenda: I know how much harder this becomes as you get older. I was allowed to adopt bad habits that are hard to break, and that shows why we need to educate the next generation to do much better.

School food has played a role in public policy for more than 100 years. It was first discussed in this place in 1906 when Fred Jowett, former Member of Parliament for Bradford West, used his maiden speech in the Chamber to launch his campaign to introduce free school meals when compulsory education was being rolled out. That led to the passing of the Education (Provision of Meals) Act 1906, which was originally Jowett’s private Member’s Bill.

Jowett’s campaign was driven by his experience as a member of the Bradford school board, where he witnessed the malnourishment of children who then fell behind their more affluent peers. Here we are, more than 100 years later, and those arguments are still being made today.

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

I was just thinking the same as my hon. Friend about how far we have come in some respects but not in others. She will be aware of the private Member’s Bill of my right hon. Friend the Member for Birkenhead (Frank Field). Does she support it?

[Mrs Hodgson]

Yes, that private Member’s Bill is an excellent initiative, and should be adopted by the Government and local authorities. It is very simple to share the data that we already have on families who are entitled to benefits, to ensure that the entitlement of their children to the pupil premium is not lost when universal free school meals are rolled out. That is a very important point.

Although we do not always think about obesity in this way, it is a form of malnourishment. What we are seeing today is very similar to what we saw more than 100 years ago, with children lacking the right nutrients to see them living a healthy childhood and growing into healthy adults. That is especially concerning given that today more than one third of children are leaving school overweight or obese.

The school setting is one of the most important interventions in a child’s life; it is where we nurture and educate future generations. Why should we not feed these children so that they are fuelled to receive the best education and life chances possible? That notion was strongly supported by the previous Labour Government, who introduced a raft of measures that addressed the food eaten by children in our schools. They included nutrition-based school food standards that provide children with the proper nutrition to learn, fully costed plans to extend our universal free school meal pilots, and the introduction of healthy, practical cooking on the national curriculum.

Although much, or all, of those measures were scrapped when the coalition Government were formed in 2010, it was very welcome when, in 2013, the school food plan was published, calling for the reinstatement of lots of those measures as well as new and improved measures in our schools to address the health of our children. Those included introducing food-based standards for all schools, training head teachers in the benefits of food and nutrition, improving Ofsted inspections on school food, and the roll-out of universal free school meals for primary school children, when funding was found.

As we know, that funding was found, thanks to David Laws and the right hon. Member for Sheffield, Hallam (Mr Clegg). Fortunately, universal infant free school meals were secured by the Chancellor in the comprehensive spending review. All those measures came out of concerns for the health of our children and the growing obesity crisis, especially given that 57% of children were not eating school lunches. Some were opting to take in packed lunches, only 1% of which met the nutritional standards of a hot lunch, while others were opting to go off site to eat junk food at local takeaways.

As research has found, health problems associated with being overweight or obese cost the NHS more than £5 billion a year, and, with obesity rates continuing to rise for 11 to 15-year-olds, especially in deprived areas, it is now clearer than ever that we need seriously to address childhood obesity.

Giving children a healthy and balanced diet during the school day can only be a positive intervention in helping to address obesity. I cannot stress how strongly I believe that one of the most important interventions to help address health issues in childhood is universal free school meals.

--- Later in debate ---

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

I pay tribute to the Backbench Business Committee for allocating time for such an important debate and to the hon. Member for Totnes (Dr Wollaston) for her eloquent opening speech. I also extend my thanks to the entire Health Select Committee for producing such a comprehensive report on childhood obesity. She was dead right to entitle it, “Childhood obesity—brave and bold action”, because that is precisely what is needed. I would also like to thank for their contributions my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), my right hon. Friend the Member for Leicester East (Keith Vaz), my hon. Friend the Member for Swansea West (Geraint Davies) and the hon. Members for Colchester (Will Quince), for St Austell and Newquay (Steve Double), for Strangford (Jim Shannon), for Mid Worcestershire (Nigel Huddleston), for Twickenham (Dr Mathias), for North Ayrshire and Arran (Patricia Gibson), for Erewash (Maggie Throup), for Glasgow Central (Alison Thewliss), for Portsmouth South (Mrs Drummond) and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I am sure I pronounced that kind of right.

Returning to the Select Committee report, the starting point has to be the scale and the consequences of the problem, and this requires looking at doing things differently. Failure to act will make the problem worse—not just for the individuals concerned, but for the public purse, which will, frankly, struggle to cope with the health inequalities that we are exacerbating.

The statistics are clear. Childhood obesity is strongly linked to deprivation, almost reversing the trend of the entire history of the human race whereby malnourishment, not obesity, was the key indicator of poverty. As we know from the statistics of Public Health England, the most deprived children are twice as likely to be obese at reception and at year 6 than the least deprived children—and that gap is widening, as the hon. Member for Totnes set out.

We often get into the habit of praising the fact that a debate is even taking place here, but in this instance, the timeliness of the debate really cannot be overstated. It is no understatement to say that the Government’s strategy has been a long time coming. Although we are debating obesity today, I hope that this is not a sign that the document is being slimmed down. Today’s debate has suffered from the slight disadvantage of addressing the contents of a document that does not yet exist. Perhaps the Minister will give some certainty—perhaps even a date—on when we can expect publication of the strategy. This also presents a rare opportunity, hopefully, to influence what will eventually be published in that strategy. It is important to remember that Government can do immense good when it comes to public health.

If we think about some of the great strides in public health that we have taken in recent years—from the banning of smoking in public places to reducing the rates of teenage pregnancy—we realise that these moves came about, in part, as a result of Members putting difficult issues on to the political agenda. With that in mind, I shall focus my remarks today around the key issue of obesity and diet.

I believe that we need action to tackle the problem at the supply side on the part of food and drink companies, and also action to tackle it on the demand side, with a need for far better education on how we could be looking after ourselves, as well as give people the means to eat healthier food. We believe a comprehensive and broad approach is necessary to help families, schools and children to make the right decisions. I commend the work of my hon. Friend the Member for Washington and Sunderland West, who has long been a champion of better standards of food in our schools.

In November, the Health and Social Care Information Centre released data showing that one in every five children leaving primary school are classified as obese, and one in every three children are either obese or overweight. Frankly, those figures should shame each and every one of us. Although there has been a shift in providing healthier, more nutritious meals at schools, so many of the problems start before school or at least outside of school hours.

Between April and September 2015, Trussell Trust food banks in Greater Manchester, which includes my constituency, gave 22,739 three-day emergency food supplies to people in crisis. Some 8,666 of those three-day emergency food supplies were given to children. When so many families are having to rely on food banks to feed their children, they may be limited in their ability to provide fresh and healthy meals. In these upsetting circumstances, feeding their child something is better than seeing them go hungry. Wider problems of poverty must be addressed to ensure that people have access to good diets. How does the Minister plan to help families who are having to rely on food banks to improve their diets?

Funding is a crucial side issue. Following the removal of protected status from all Department of Health budgets that are not controlled by NHS England, the pot of money that pays for public health will be subjected to huge cuts in the coming years. That will have a significant impact on Public Health England, and could put at risk our ability to tackle obesity to the necessary extent. It could also put at risk the future of public awareness campaigns, many of which have been a great success. The cuts in the public health grant to local authorities could drastically reduce the amount of support that is available locally to those who want to lose weight or have a healthier lifestyle. I should be interested to hear from the Minister how the public health cuts in the coming years are consistent with the emphasis on prevention in the “Five Year Forward View”, and, in particular, whether the crucial issue of funding will be addressed in the forthcoming strategy.

[Geraint Davies]

Obviously funds are tight, but does my hon. Friend agree that if we introduce a sugar tax, it will ease the burden and enable us to focus our fire on reducing obesity in other ways?

[Andrew Gwynne]

That may well be the case, but we must of course ensure that any income raised by such a tax is reinvested in public health.

It is also important to increase levels of physical activity among adults and children throughout the United Kingdom. Inactivity is a key factor in ill health, and it is important that we encourage children to maintain active lifestyles from an early age. I believe that increasing the opportunities for young people to get involved in physical activity is just as important as improving diets. Treating obesity and its consequences alone currently costs the NHS £5.1 billion every year. Given that nearly 25% of adults, 10% of four to five-year-olds and 19% of 10 to 11-year-olds in England are classified as obese, the human and financial cost of inaction is significant. We must do much more to ingrain physical activity in our daily lives, whether that means walking instead of driving or taking the stairs instead of the lift. Every little helps.

A number of Members have touched on a point that is crucial to the debate. Many people have argued that the Government should introduce some form of tax on sugary products, particularly soft drinks, and the debate on that issue goes far beyond the Chamber. Public figures such as Jamie Oliver have come out in support of a sugar tax, and he has made a compelling case. However, the issue is complex, and I do not think that the answer is necessarily straightforward. Labour Members have always feared that a sugar tax, in itself, could be regressive, and that it would focus attention on consumers, many of whom are addicted to sugar, rather than manufacturers, who should be reducing the amount of sugar in their products. That said, however, I suggest to the Minister that it is right for us to look at the emerging evidence from other countries, which has shown that where similar taxes have been introduced they have had a positive effect, not least in changing behaviour.

[Will Quince]

Will the hon. Gentleman give way?

[Andrew Gwynne]

I am afraid not. I do not have time.

It has not escaped my attention that the Prime Minister has effectively gone from ruling out a sugar tax to not ruling out a sugar tax. I hope that the Minister will clarify the Government's position, but, in any event, it seems that the forthcoming strategy will mark a departure from the ineffective voluntary approach that they have favoured in recent years. The public health responsibility deal has seen firms making all sorts of promises and then hijacking the agenda to promote their own products, ultimately failing to fulfil their pledges. At the time of its introduction, organisations such as the Royal College of Physicians and Alcohol Concern complained that the pledges were not specific or measurable, and that the food and drink industry had simply dictated the Government’s policy.

I hope that the Government will take a much stronger line with industry than it has taken previously, because it must be incumbent on industry to reduce the amount of sugar in products, including comparable products in the European Union that are boxed in exactly the same way, but contain significantly different amounts of sugar and other ingredients. I also hope that if the Government are forthcoming with a fiscal solution, that is part of a much larger and comprehensive strategy of measures. I do not think anyone would try to argue that a sugar tax on its own is a silver bullet. I want food and drinks manufacturers to reduce sugar in their products, and we need to ensure that that happens.

I thank everyone who has spoken in the debate, and I hope the Minister will consider the many excellent contributions when the Government put the final touches to the childhood obesity strategy.

Cancer Drugs

Andrew Gwynne Excerpts

Tuesday 19th January 2016 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate the hon. Member for Mid Derbyshire (Pauline Latham) on securing this important debate and on the depth of knowledge she has demonstrated. We might not share the same political allegiances, but we share a commitment to improving the lives of people affected by cancer, as do all Members—those who have contributed to the debate and all those in the House of Commons. The nature of the cross-party debate we have had today stands as a testament to that. I thank my hon. Friend the Member for Scunthorpe (Nic Dakin) and the hon. Members for Strangford (Jim Shannon), for Solihull (Julian Knight), for Bury St Edmunds (Jo Churchill), for South Down (Ms Ritchie), for South Antrim (Danny Kinahan) and for Motherwell and Wishaw (Marion Fellows) for their contributions too.

Cancer transcends party politics. Each and every one of us has had a constituent, family member or friend affected by cancer. It is a disease that sadly touches us all, and it deserves the proper attention of the House of Commons. It is because it transcends party politics that I commend the Government on introducing the Cancer Drugs Fund during the last Parliament. Patients have benefited significantly since the fund’s introduction, and that has to be welcomed. However, we are here today because the progress over recent years to improve access to cancer drugs is now partially at risk.

The Government introduced the Cancer Drugs Fund, but they are now sadly presiding over damaging cuts to the treatment available through it, as we have heard in the debate. At the general election, the Conservatives promised to continue to invest in cancer drugs, but less than six months later they announced that a number of treatments would be removed from the fund, meaning that they would no longer be routinely available to patients. That will have a tragic human cost for cancer patients. Indeed, the Rarer Cancers Foundation has calculated that the reductions could affect as many as 4,100 cancer patients every year. Members from all parts of the House have expressed significant concerns about the impact those reductions will have on all our constituents.

Many important points have been made during this debate, but I would like to add a few of my own. First, can the Minister, whom I have a great deal of respect for, tell us what support is being made available to patients who will now miss out on treatments that have been removed? Will he promise that this is the last time we will see cuts of this nature? The sad truth is that the cuts were an inevitable consequence of an abject failure by Government to fix the drugs pricing system. The Cancer Drugs Fund was always meant to be a temporary measure, but the inability to implement value-based pricing and then value-based assessment during the last Parliament has to some extent led us to the situation we are in today. Cancer Research UK has said that it is

“unacceptable that after five years of conversation, there still isn’t an effective solution in place,”

and I agree. We need a better system of drug pricing that is fair for patients and has the confidence of doctors. At the moment, patients are being badly let down.

Before the election, Labour promised to reform the Cancer Drugs Fund to make it a cancer treatment fund and end the bias towards certain types of treatment. We also promised reform of NICE to ensure a clear route for new treatments to be made available on the NHS. Nobody wants a return to the days when people’s access to treatment was determined by the first two characters of their postcode. Unfortunately, however, the latest promise of reform of the Cancer Drugs Fund has been riddled with confusion and delay. Ministers said the consultation would be published in July, then September, and it finally came out in November. The consultation is expected to run until mid-February, with a new system ready to be in place by April this year. The Minister might be able to hear the scepticism in my voice about whether the Government can deliver meaningful reform of the Cancer Drugs Fund in such a short period, so will he confirm, secondly, that these are still the timescales for delivering reform? If so, will he promise us that the outputs from the consultation will deliver the change being demanded by the cancer community and not leave a half-baked solution?

Although some aspects of the Cancer Drugs Fund proposals are to be welcomed, others cause concern. Beyond some tweaks at the edges, it is not clear that NICE is proposing the fundamental changes to its processes that charities have rightly requested. Breast Cancer Now has warned that the consultation

“does not offer sufficient changes to the way NICE currently operates...to allow drugs to be approved for routine use on the NHS.”

The charity has also said that it is

“concerned that these proposals may result in fewer drugs being made available rather than more.”

Those are troubling comments, so, thirdly, will the Minister respond to those concerns? Can he tell us the extent to which final decisions about treatment access will differ under the reforms? Which drugs that have previously been rejected by NICE will be available?

NHS England has not published an impact assessment for the Cancer Drugs Fund consultation. Members of the cancer community have raised concerns about that with me and asked what NHS England might be attempting to hide, so can the Minister confirm, fourthly, whether NHS England has carried out an impact assessment on the proposed changes? If so, will he promise to place a copy in the Library before the consultation closes, so that Members of this House can give it the scrutiny it deserves?

Beyond the current planned changes, there are disturbing stories of NHS England refusing to discuss price cuts with drug companies, effectively leaving deals on the table that could have helped patients and the taxpayer. Simon Stevens once said that he wanted NHS England to:

“Think like a patient, act like a taxpayer.”

At the moment, it is frankly doing neither. We cannot allow red tape to get in the way of what is right for patients. The reforms must create greater flexibility and pressure for both sides to get round the table and agree deals. Other countries seem to be able to make the drugs available without spending more money on their health services, which implies that they are better at striking deals, or at least are more flexible in doing so. Therefore, fifthly, will the Minister promise to intervene in NHS England to ensure it is doing everything it can to secure the best deal from industry for patients and taxpayers? Will he commit to reviewing the processes carried out in other countries for securing access to medicines and ensure that learnings from them are translated into NHS England’s new system?

It is also worrying that the drugs companies and the Secretary of State have negotiated a deal in secret that changes the drugs pricing scheme, effectively creating a half-a-billion-pound funding black hole over the course of the pharmaceutical price regulation scheme. I am fearful that that could lead to more bad news for cancer patients. I have pressed the Minister on that before, so will he tell me, sixthly and lastly, how that funding gap will be filled? Will he guarantee that the shortfall will not lead to any further damaging cuts in cancer patients’ access to treatments?

I want to end my contribution to this debate in the spirit in which I started, because this is not a party political issue. Our shared goal is an NHS that is the best health service in the world for treating cancer, but we will only achieve that if we can ensure that patients can access the most effective forms of treatment. Cancer patients need and deserve an end to the current uncertainty. We on this side of the House will stand with the Government to do all we can to ensure that cancer patients get that fairer deal.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

It is a pleasure to serve under your chairmanship, Mr Streeter. I congratulate my hon. Friend the Member for Mid Derbyshire (Pauline Latham) on securing this debate and I thank her for the chance to discuss these important issues, which I know are important to various Members who cannot be here this afternoon. I thank colleagues of all parties who have spoken. It was particularly powerful to hear the personal perspective of my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is a cancer survivor. I pay tribute to the work of Myeloma UK, Cancer Research UK, Macmillan and the other charities that have done, and continue to do, so much work looking after patients and supporting policy and research. As colleagues know, I am passionate that charities should have a bigger role to play in policy making. I have opened the Department’s door and invited them to come to the top table.

Few families in the country are untouched by cancer, and I am no different. My father died of throat cancer when I was 19, 18 months after I had met him. My mother-in-law died of myeloid leukaemia a few years ago. The family, like so many families, had to watch her go from a wonderful and healthy, vibrant grandmother to a corpse in 12 to 15 months. It is a tragedy when it happens, but the truth is that our generation has lived through the most extraordinary advances in cancer. Certainly in my childhood it was a death sentence. One sat in the back of cars as a child and heard parents discussing in hushed tones that somebody had a cancer diagnosis, which meant they would die. Now that has changed: 2 million people live with cancer and it has become a treatable disease. In some cases, it has become a preventable disease. That is why it is such a pleasure to see my hon. Friend the Member for Bury St Edmunds here. Many others in the country today work and live with cancer. It is a stunning tribute to the success of our life sciences sector and our academic and clinical scientists.

My hon. Friend the Member for Mid Derbyshire talked about Tina and Graham and their experience of cancer. We should always remember—I do every day—that at the heart of difficult policy decisions there are people living with the disease. As constituency MPs and parliamentarians we need to bring that personal perspective to policy making. Certainly as a Minister I try to do that. My hon. Friend highlighted the trauma experienced by patients who, at diagnosis, think they will be eligible for a drug but find they have been caught by the timing of the CDF review, which means that the drug is tantalisingly taken away from them. We can all sympathise with that. As in all Administrations, when change comes, somebody normally gets caught at the point of change and it is very difficult. My hon. Friend also made a powerful point about data being crucial, and I accept that we need to do better on data. I have picked out those comments, but we have had excellent comments from across the House.

I want to set the context before dealing with specific questions. In the past 20 or 30 years, we have seen incredible transformations in biomedical research and in our ability to develop new treatments and diagnostics. My own 15-year career in biomedical research saw us go from the early days of genetics to extraordinary abilities to drive diagnosis and personalised therapy. One looks at Herceptin for breast cancer, a genomic biomarker theranostic partner drug. We have guaranteed that it works in patients who have that genetic biomarker. This is the future: much more genomic targeting of drugs. Genomics and informatics are transforming the way in which drugs are developed.

I arrived in the House of Commons six years ago. As a Government adviser on life sciences, I supported the Prime Minister in putting a life sciences strategy in place that built on the previous Government’s good work. We set out an ambition for the NHS to become not only a passive recipient of new therapies, but an active partner in the development of them, making available our genomic and informatics leadership and our clinical research, which is at the heart of the life sciences strategy: two cylinders pumping together, with the NHS not just as a purchaser but a partner in development.

Although we have had phenomenal revolutions in genomics and informatics and in the pace of discovery—pioneered in cancer, which is why cancer has led with this pressure on our funding mechanisms—they give rise to great challenges: rising costs of treatment; ever more expensive drugs; smaller patient catchments, which puts a coach and horses through the traditional model of reimbursement; and the end of a one-size-fits-all blockbuster model of drug discovery, which is what NICE was originally set up to deal with. Those are very big challenges and I am putting policy responses in place. However, they are also big opportunities. As the world’s only integrated comprehensive healthcare system, nowhere is better equipped in the world to unleash the power of genomics and informatics for public good. I believe Nye Bevan would be banging the table today and saying, “The NHS was about the collective use of our health assets to prevent disease. Come on! Let’s harness the extraordinary ability of our NHS,” which is what we are doing.

As we reform the way in which NICE works, there is an opportunity for us to take the lead in the development of these new drugs and new specialised therapies, and to pioneer new models of reimbursement as well. It will not happen overnight—that is the honest truth—but it will happen over the next few years. That is why we have set out a 10-year strategy, and I am absolutely honoured and privileged to be at the beginning of a five-year Parliament as the Minister for Life Sciences with a chance to drive the reforms through. That is at the heart of the accelerated access review that I have launched, which I will talk about in a moment.

I urge everyone to recognise that the Government are not complacent. We have put £250 million extra into Genomics England. We are the first country on earth to do, at scale, full genome sequencing in cancer and rare diseases. Rare cancers are particularly well served. We have led on data and informatics for research in the NHS, often at a high political price, but it is essential if we are to drive this forward. We have set up the precision medicine catapult, the cell therapy catapult and the £700 million Crick Institute. We have protected, increased and ring-fenced science budget increases. We have announced and secured a multi-billion pound drugs budget, and more on that will be announced shortly. We have set up the rare diseases consortium, the accelerated access review, the early access to medicines scheme and a £1.2 billion commitment to the Cancer Drugs Fund, so I hope colleagues will acknowledge, as some have, that we are serious about trying to both invest in and reform this space.

The Cancer Drugs Fund was set up with strong leadership from the Prime Minister. Because of the progress in cancer putting pressure on NICE’s systems, NICE’s clinically led, world class, independent advice rejected many of the new cancer therapies that did not fit well with its scoring system, so the Prime Minster said that we must make the money available to make sure cancer patients do not suffer while we reform the system. The fund is now £1.2 billion; another £340 million was invested this year. Some 84,000 people have received life-extending drugs that they would not otherwise have got.

[Andrew Gwynne]

The situation is worse than described. There were drugs that NICE had approved, but the primary care trusts refused access to those treatments.

[George Freeman]

The hon. Gentleman makes an interesting point about the balance of responsibilities between NICE and NHS England. The system was set up so that NHS England is statutorily bound by NICE’s recommendations. Part of the problem in recent years has been that even treatments approved by NICE can take up to two, three and in some cases five years to be rolled out across NHS England. Much as we all love the NHS, we accept—even the NHS accepts—that there is a problem with patchy roll-out. That is also to do with data, which various colleagues have touched on.

Oral Answers to Questions

Andrew Gwynne Excerpts

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?

Tobacco Control Strategy

Andrew Gwynne Excerpts

Thursday 17th December 2015 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Betts. I begin by thanking the Backbench Business Committee for granting the debate, and I take the opportunity to wish all hon. and right hon. Members, the Clerks and everyone else sitting in this room a very merry Christmas.

Clearly, it is always a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford), because she speaks about these issues with such passion and a great deal of knowledge. She adds greatly to our debates. The need for a strategy and for funding to make it happen is pressing, and I am glad we have had the chance to discuss it today. I thank my right hon. Friend the Member for Rother Valley (Kevin Barron). His interest in the issue is, as we are all fully aware, not just passing; he has been championing the issue for a great number of years, and I commend him and the hon. Member for Harrow East (Bob Blackman) on the work that they have done on it through the all-party group.

I start with the problems with the autumn statement—an issue raised by all Members who have contributed so far. It is clear that the autumn statement brought yet more cuts to the public health grant. As a result of year after year of cuts to public health budgets, there has been a consistent fall in the number of people using local smoking cessation services. It is not the kind of thing that can be done half-heartedly. We can throw a little cash at the problem and suggest we are tackling it, but if we spend too little, the returns will be minimal. We may as well spend a sufficient amount and enjoy much greater returns on the investment in public money. We all know that a smoker may throw themselves into an attempt to stop—usually in the new year period, following a new year’s resolution—but if the support is not there, many of them might fail in their attempts. Even worse, after a failed attempt with insufficient support, they are unlikely to try again; that is just human nature. It is worth getting it right the first time round, and giving people the support that they need. That is why some of the cuts to the public health budget have been short-sighted and are the falsest of false economies.

I fear that most smoking cessation services will not survive a 24% cut to the non-NHS part of the Department of Health’s budget. I want public health bodies to be able to push to make children born today the very first smoke-free generation, but I am worried that their ability to do so will be damaged by the reduction in funds.

Let us consider just one aspect of the cost of smoking that may be overlooked. The general health implications of smoking are well known and documented, but mouth cancer often gets overlooked. Oral cancer kills more people in the United Kingdom than cervical and testicular cancers combined, yet there is still an alarming lack of public awareness about oral cancer. Nine out of 10 oral cancer cases are preventable, and two thirds of cases are a direct result of smoking, so improved awareness of all the possible health problems caused by smoking is one role of local public health services. Awareness as a concept can often be dismissed, but when it comes to deterring people from using tobacco products, it is invaluable, yet such services will be slashed in the upcoming public health bonfire. I call on the Government and the Minister, for whom I have a great deal of respect, to think again and try to reverse some of the cuts to public health services.

I welcome the introduction of standardised packaging for cigarette packets by May next year. There are powerful arguments in favour of it, and I am pleased that the Minister pushed ahead with the policy, with cross-party support, albeit that there were a few recalcitrant members of Government, and even louder voices against on the Back Benches. Nevertheless, we got that through, and I commend her on the work she did in pushing for that.

This month marks the third birthday of plain packaging. Australia’s Tobacco Plain Packaging Act 2011 came into force on 1 December 2012, which made it the first country to halt the use of figurative trademarks on tobacco products. In the past few months, both France and Canada have taken significant steps forward in introducing a similar ban. France should be introducing a ban in May, at the same time as our standardised packaging laws come into force.

The importance of removing legitimacy from such activities cannot be overstated. Take the example of the ban on smoking in cars, championed by my predecessor as shadow Public Health Minister, my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger). The purpose is obviously not to punish every single driver smoking in a car with children; that would be impossible to enforce. The real purpose is to send a very strong message that it is not acceptable to smoke in cars with children, and that it is punishable by law. A similar example is the ban on driving without a seatbelt. There are not many convictions, but the number of people using seatbelts soared after the ban was introduced. Our approach must include encouragement as well as enforcement.

I come on to my main point. The previous tobacco strategy was, on the whole, a success. It has encouraged the introduction of measures such as standardised packaging, which are to be welcomed, but I am concerned that a new strategy has not been developed yet. I welcome the Government’s commitment to establishing a new strategy in the new year, but I have concerns about their ability to implement it fully and comprehensively.

In October last year, the five-year forward view noted that

“The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”

As the hon. Member for Central Ayrshire said, Simon Stevens has gone on record to say that as part of the efficiencies that the NHS is looking to implement, £5 billion will come from prevention, but how can we achieve £5 billion in prevention when preventive services are being cut back—or, in some cases, removed altogether? I hope the Minister can give Members of all parties, who want the same outcomes, assurances that cessation and other public health services at a local level will not see the axe fall on them in the way it is suggested they might, and that the £5 billion of efficiencies that Simon Stevens has identified as coming from prevention are achievable through the role and remit of the Minister with responsibility for public health.

I will return to the point that I opened with. A person is four times as likely to quit smoking successfully with the help of specialist support, but those services are under attack. In the autumn statement, the Chancellor announced further cuts in the public health grant, amounting to an average real-terms cut of 3.9% each year to 2020-21. That translates to a further cash reduction of 9.6%, in addition to the £200 million-worth of cuts announced in the summer Budget.

Meanwhile, tobacco, as we have heard from other Members, is still the single biggest cause of premature and preventable death, responsible for 100,000 deaths every year in the UK. Some 10 million adults still smoke. More than 200,000 children aged 11 to 15 begin smoking every year. This is an income inequality issue, too. In 2014, 12% of adults in managerial and professional occupations smoked, compared with 28% in routine and manual occupations. People with mental health conditions, prisoners and the homeless are far more likely to smoke than the general population. In my constituency, smoking rates are still far too high and well above the national average. In Tameside, where smoking is prevalent—a quarter of the population smokes—450 deaths a year and 2,500 hospital admissions are attributable to smoking. I know how much this contributes to poor health, which places a huge pressure on health and care services locally, and causes untold misery for the communities and the families of those affected.

I want to touch briefly on the point made by my right hon. Friend the Member for Rother Valley about e-cigarettes, because I have seen them work for people who have smoked for a very long time. The e-cigarette not only helped to wean them off tobacco, but, by reducing nicotine levels over a long time, removed the need for nicotine and got them off cigarettes altogether. I implore the Minister to ensure that any regulations she introduces are proportionate, as my right hon. Friend said.

I ask the Minister to keep a watching brief, though, because I am a little concerned. I am starting to see in my constituency the glamorising and normalising of smoking among young people through the use of e-cigarettes. I fully support them as a product to help people come off smoking, but as a gateway product to smoking, they worry me considerably. I accept that there is probably nothing more than anecdotal evidence at this stage, which is why I urge the Minister to keep a watching brief, but having seen the marketing of some e-cigarette products, I am concerned that it uses precisely the same marketing tactics as we saw used by tobacco companies, which brought about the introduction of the regulations on standardised packaging. Let us make sure that e-cigarettes are used for their correct purpose: to bring people off smoking. If there is evidence that they are starting to become a gateway product to smoking, I hope very much that the Minister will look again at whether action is required.

Health inequality is one of my biggest bugbears, and smoking is one of its most virulent causes. A comprehensive strategy to reduce smoking rates is imperative if we are to tackle the issue. The Opposition will support the Minister with responsibility for public health and the Government in developing such a strategy, building on the achievement of both her Government and the previous Labour Government over a number of years. I hope that she can give some assurances on the issues that Members have raised, and some Christmas cheer to Members looking for a renewed strategy on this very important issue.

Victims of Contaminated Blood: Support

Andrew Gwynne Excerpts

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.

Cystic Fibrosis

Andrew Gwynne Excerpts

Tuesday 8th December 2015 Westminster Hall

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

It is a pleasure to be back, having spent four and a half weeks in cold, wet Oldham, running the Labour party by-election campaign. I pay tribute to my fellow shadow Ministers for standing in for me in numerous Westminster Hall debates. It is good to be back, and it is good to see you in the Chair, Sir Edward.

I pay tribute to my hon. Friend the Member for Dudley North (Ian Austin) for making sure that this important debate could take place. He is right that we need to make sure that access to pharmaceuticals is one of the most important policy areas. With the results of the accelerated access review coming out in the new year, the effectiveness of NICE is very much on the agenda.

I also pay tribute to the right hon. Member for Chesham and Amersham (Mrs Gillan), who spoke powerfully about not only Archie, but Duchenne muscular dystrophy, which is a terrible disease, and she is right that we need to do much more to make sure drugs are available to treat it. I hope the case she made for Translarna will not fall on deaf ears with Ministers, because such drugs can make a big difference to the quality of life of children such as Archie. The right hon. Lady has put that case very powerfully in her question to the Prime Minister, and in her contribution today.

In June 2009, the previous Labour Government adopted the European Council recommendation on action in the field of rare diseases, which recommended that member states should establish and implement plans and strategies for rare diseases. Following on from work set out before the 2010 election, the coalition Government published the UK strategy in November 2013. NHS England published its statement of intent with regard to the UK strategy in February last year.

Since then, we have had the five-year forward view, which reaffirms NHS England’s commitment to achieving better outcomes for people with rare diseases, and when the Minister concludes the debate, I am sure he will give us more detail about how he sees the points made by my hon. Friends the Members for Dudley North and for York Central (Rachael Maskell), the hon. Member for Strangford (Jim Shannon) and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads for the SNP on these matters, and the right hon. Member for Chesham and Amersham. Rare diseases are a crucial part of the five-year forward view, and given that the UK leads in life sciences, there is no reason why we cannot start to push the boundaries on what is achievable in respect of the drugs available for rare diseases.

The problem is that, although each of the publications I mentioned set out some laudable intentions, the actions arising from those publications have been baby steps in comparison with what we actually need. Changes resulting from the Health and Social Care Act 2012 have left patients and professionals to navigate a labyrinth when accessing medicines that, in many cases, have already been approved or have received licences. That really should not be happening.

Before the last election, the Opposition said unambiguously that we would reform NICE from top to bottom to remove the requirement to enforce competition rules and to ensure that access to medicine was decided on the basis of a medical justification, balanced with consideration of how much money we had available. I think we all now agree that NICE needs some reform. The current appraisal system makes decisions based on 24 weeks of clinical trials data, but that understates the efficacy of drugs that provide long-term stabilisation of a condition.

Other Members have spoken of the frustration cystic fibrosis patients have felt at not being able to access new treatments because those will not be approved given the way NICE appraises them. As my hon. Friend the Member for York Central said, the NICE system is not set up to assess precision medicines, and the issue extends well beyond cystic fibrosis to other rare diseases. Members have spoken powerfully about cystic fibrosis, and what we have heard about could be an excellent platform for testing new ways of doing things, and that could, indeed, also be the case with muscular dystrophy. The appraisal system for innovative medicines needs to be overhauled and to be adapted to include personalised medicines. Until the system is prepared to look at the value of new medicines over time, instead of looking for more rapid effects, it will not be suitable for its purpose.

I have some specific questions for the Minister. I am concerned that the highly specialised technologies evaluation programme could limit access to medicines for people with rare diseases. There are widely held concerns that the process, which was introduced after the 2012 Act to appraise medicines for rare diseases, is opaque and that the topic selection process is out of date. Does the Minister have plans to work with NICE to update the selection criteria for the pathway? Am I right that the process does not take into account conditions defined by genetics, biomarkers or differences in clinical presentation? Will he look again at that? Will he, as other hon. Members have asked, meet representatives of Muscular Dystrophy UK and the Cystic Fibrosis Trust to discuss those matters?

I accept that there has been huge investment in life sciences in the UK, but the current system, which encourages investment in technology and does not facilitate patient access to it, is unsustainable and wrong. Without such reform as we have discussed, funding for research on the relevant medicines could dry up and we could lose crucial shots at tackling a lot of rare diseases once and for all. The accelerated access review is a timely opportunity to take a careful look at how people get access to the kinds of medicines that might change their lives. It would be a tragedy if we threw that opportunity away.

I do not doubt for a moment that the Minister is fully behind every Member taking part in the debate in wanting to expedite the availability of the drugs in question, and I am keen to hear more about how the Government plan to do that. I commend Members for speaking so powerfully in a consensual cross-party manner in today’s debate and at other times when we work in Parliament to promote such causes. I hope that the Minister will answer all the questions that have been asked, and offer a glimmer of hope for those people who seek access to such drugs.