Health: Mental Health

Debate between Baroness Sherlock and Earl Howe

Wednesday 21st November 2012 Lords Chamber

[Baroness Sherlock]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as a director and former chair of Chapel Street community health.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, the Health and Social Care Act 2012 creates equal status for mental and physical health; the new mandate to the NHS Commissioning Board tasks it with delivering this goal. One of the eight objectives of the mandate is,

“putting mental health on an equal footing with physical health–this means everyone who needs mental health services having timely access to the best available treatment”.

The NHS will be expected to demonstrate progress by March 2015.

[Baroness Sherlock]

I thank the Minister for that Answer. The NHS constitution gives a patient the right to drugs and treatment recommended by NICE for use in the NHS where clinically appropriate. “Recommended” means that they have passed NICE’s technological appraisal. For mental health, the problem with talking therapies is that they are not appraised because they are not technological. Will the Minister reassure the House that “parity of esteem” will mean that the NHS constitution will give someone the right to any therapy or treatment recommended by NICE for use in the NHS, even if it has not passed the technology appraisal, provided that there is good evidence for its efficacy—for example, CBT for schizophrenia?

[Earl Howe]

My Lords, as the noble Baroness made clear, the NHS constitution sets out that patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS if their doctor says that they are clinically appropriate for them; that includes talking therapies for certain problems. The mandate to the NHS Commissioning Board is clear about everyone who needs mental health services having timely access to the best available treatment. The NHS will be expected to demonstrate progress in achieving that by 2015, as I mentioned. For many patients, there are few better therapies than talking therapies. Given that the board must deliver those outcomes, the rest follows.

Health: NICE

Debate between Baroness Sherlock and Earl Howe

Wednesday 3rd November 2010 Lords Chamber

[Baroness Sherlock]

To ask Her Majesty’s Government which groups were consulted prior to the announcement that the National Institute for Health and Clinical Excellence was to lose the power to decide that some drugs may not be supplied by the National Health Service.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, it is important to make clear that the National Institute for Health and Clinical Excellence does not have any powers to ban the use of drugs in the NHS, so suggestions that this is a role that will be removed from it are based on a misunderstanding of the position. Our NHS White Paper makes it clear that the role of NICE will continue and, indeed, that it will be extended.

[Baroness Sherlock]

My Lords, I thank the Minister for that Answer. I am a little confused, but perhaps he can help me to understand the change. In the world that he envisages, is it intended that every single GP consortium will take its own decision about which drugs it is willing to fund? If that is the case, will it be about every single individual drug or treatment? And, if that is the case, can the Minister explain how he will protect patients from the uncertainty and confusion that must arise from a return to a postcode lottery of that magnificence?

[Earl Howe]

My Lords, currently the NHS is faced with the decision of whether to say in effect yes or no to a new drug at the price that is proposed by a pharmaceutical company. We want to change that so that the price of a drug to the NHS is based on an assessment of its value, rather than pharmaceutical companies being free to set whatever price they choose and expecting the NHS to pay. So value-based pricing, which is the term we have used, will ensure that licensed and effective drugs are available to NHS clinicians and patients at a price to the NHS that reflects the value that they bring. That should get rid of the postcode lottery.