Penrose Inquiry

Debate between Andrew Miller and Jane Ellison

Thursday 26th March 2015 Commons Chamber

[Jane Ellison]

Yesterday’s written ministerial statement was just what I said it would be in the Backbench business debate on 15 January: an interim response to a very long and detailed report. All matters will have to be considered in a substantive response by the next Government.

[Andrew Miller (Ellesmere Port and Neston) (Lab)]

Will the Minister reflect carefully on paragraphs 111 to 113 of the Science and Technology Committee’s Legacy report on variant CJD? The Minister gave compelling evidence to our inquiry; the one area of difference was the long-term protection of research funding to give public confidence. Will she look carefully at that and put her response in the public domain?

[Jane Ellison]

I will certainly look at that matter, but I fear that I may not have time to put a response in the public domain. I can give an assurance to the Select Committee that were I to be in office in the next Parliament I would be happy to respond to that in detail. As the hon. Gentleman knows, we have had detailed exchanges on such matters over the past year.

Blood Safety (Variant Creutzfeldt-Jakob Disease)

Debate between Andrew Miller and Jane Ellison

Thursday 29th January 2015 Westminster Hall

[Jane Ellison]

I will come on to talk about the assay in some detail.

[Andrew Miller]

I find the Minister’s remarks somewhat surprising. As I said in my opening remarks, the Government response alluded to unspecified “technical issues” that they would refer to the relevant advisory committee, but that committee had already recommended that the study should go ahead.

[Jane Ellison]

I will update the Select Committee further. We have already committed to submit an additional piece of work before the end of the Session.

I will say a few words about the work undertaken so far. The chief medical officer and I gave evidence to the Committee last April. The report was published in the summer and the Government response in October. In that response, the Government committed to responding with a further update report to the Committee. I subsequently received a letter from the Committee with more than 20 further questions, to which I responded in November. The Select Committee then held a legacy hearing on 3 December at which Professor David Walker, the deputy chief medical officer, and I gave further evidence.

I am extremely grateful to all members of the Committee who have put the issue on Parliament’s agenda and maintained a close interest in it, something that has been clear to me in the relatively short time I have been in post. I will write to members of the Committee, as we have undertaken to do, before the end of March with further updates on some work. That will include an update on the CQC issues that have been raised, which I will not give an update on today.

Let me focus on the potential use of the vCJD blood test. In the response, we made a commitment on that, so I can focus largely on it today. There is the potential to use a prototype variant CJD blood assay, developed by Professor Collinge and his team. He leads the relevant unit, and as hon. Members might know, the MRC is concluding its latest quinquennial review of that unit.

I am pleased to report that—along with two of my Public Health England officials, Professor Noel Gill and Dr Katy Sinka—Professor Marc Turner and Dr Lorna Williamson, the medical directors of, respectively, the Scottish and the English national blood services, met Professor Collinge and his team in October 2014 to discuss the potential use of the prototype assay. At the meeting on 13 November 2014 of the transmissible spongiform encephalopathy sub-group of the Advisory Committee on Dangerous Pathogens, Professors Turner and Gill presented a paper on the possibility of using the assay to carry out an anonymised blood prevalence survey for asymptomatic vCJD, as recommended by the Select Committee.

Members might recall that the ACDP is the independent scientific advisory committee that provides the Government with authoritative advice on all forms of TSE, including all forms of CJD. During the presentation to the sub-group, the professors asked three specific questions. I will update Members on those questions and the ACDP’s responses.

First, with a view to the ability of the assay to detect sub-clinical vCJD infection in otherwise healthy individuals, the ACDP was asked if it had confidence in three qualities of the assay. The first was sensitivity, which is the ability of the assay to give true positive results; in this case, that is the true number of asymptomatic cases that the test could identify in any population. The second was specificity, which is the ability of the assay to give true negative results; in this case, that is the true number of unaffected individuals that the test would identify in any population. The third was reproducibility, which is the ability of the assay to be reliably and repeatedly reproduced outside the centre in which it was developed.

Basically, that process would be to find out whether the assay could be used to identify people with asymptomatic infection, and those who showed no clinical signs of vCJD but who would be presumed at some stage to be potentially infective and/or go on to develop clinical symptoms. My hon. Friend the Member for Mole Valley (Sir Paul Beresford) said that symptoms could develop over a very long period.

The ACDP’s sub-group discussed the issue and agreed that the answer to the first question had to be no, because it has seen no published data on the assay when used in any human or animal samples from individuals without clinically diagnosed disease. Members might recall the February 2011 paper in The Lancet that first gave detailed information on this assay. That paper provided evidence that the assay can give, in seven out of 10 cases, a positive result in blood samples taken from patients with known and clinically diagnosed vCJD. Unfortunately, however, that is not what we need if we are looking for evidence of vCJD in those with no clinical signs. There is no published evidence that provides assurance that the assay, if used in the general population, would give true positive results in those who might be carrying the infection but are asymptomatic.

If a test for this very rare disease—it has been noted that we have had only 14 new cases in the UK since 2005, and only one was after 2010—is used in presumed healthy individuals, it is essential that it is accurate. We have no evidence that the MRC assay can identify vCJD infection in an asymptomatic individual. Those in Westminster Hall with a keen interest in science will understand that undertaking a test of large numbers of individuals when we do not know what a test result means—either for those individuals or, as in this case, for the development of effective public health measures—is not the best use of limited resources.

The second question that the ACDP was asked—

Tobacco Products (Standardised Packaging)

Debate between Andrew Miller and Jane Ellison

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

The Government are not proposing to take away anyone’s freedom. Our tobacco control measures aim to prevent children from taking up smoking in the first place, which is quite a different thing. On my hon. Friend’s detailed point, Members of Parliament will, like anyone else, be able to make submissions to the final consultation. Once Members have had the chance to read the report thoroughly, any submissions they may wish to make will, of course, be most welcome and they will be considered.

[Andrew Miller (Ellesmere Port and Neston) (Lab)]

I welcome the hon. Lady’s statement and although she is right to take into account factors other than the health of the nation that have been raised by hon. Members, will she confirm that her primary consideration in handling this policy will be the health of the nation and that she will drive it through as quickly as possible?

[Jane Ellison]

I am the Minister for public health and as I said in my statement we are currently minded, based on the compelling evidence to which Sir Cyril alludes in his report, to proceed, but the hon. Gentleman will understand that policy is made in the round.

[Andrew Miller]

Health is what is most important.

[Jane Ellison]

Health is, of course, very important, particularly the health of our nation’s children, and I welcome the hon. Gentleman’s support.