All-lane Running Motorways

Debate between Clive Betts and George Freeman

Wednesday 22nd January 2020 Westminster Hall

[The Minister of State, Department for Transport (George Freeman)]

It is a pleasure to serve under your chairmanship for the first time, Mr Paisley. I am standing in for the Roads Minister, Baroness Vere, who will be watching the debate closely, and I will meet her afterwards. Let me congratulate and thank the hon. Member for Rotherham (Sarah Champion) for raising this issue. I agree that it merits a bigger debate. The participation of colleagues across the House signals the strength of feeling.

Let me start by acknowledging the tragedy, pain and trauma suffered by the families of all those who have lost their lives on our roads—especially Jason Mercer, whose family are in the Gallery, and Dev Naran—and particularly, in the context of this debate, on our smart motorways. It is no good Ministers saying that all roads are safe; people need to feel safe and be safe. We need to ensure that safety remains our No. 1 priority. We accept there is a problem here. The Secretary of State is, as we speak, putting the finishing touches on a serious package of measures to tackle it. I cannot and will not pre-empt that, but I will deal with a number of points that were raised.

I would not be doing my job if I did not start by reminding everyone that safety is our No. 1 priority. Highways England’s objective in implementing smart motorways is to ensure that they are as safe as the pre-smart motorway network, which is already the safest bit of the road network, and ultimately safer. We are committed to developing an increasingly safe road network, and I am alarmed that the safety statistics showed a slight increase last year. I take the point my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) made about drilling down into that data, which I will raise with Baroness Vere.

[Mr Betts]

What the Minister has said is interesting, but given all he has heard, does he accept that smart motorways, or all-lane running—whichever he wants to call it—are as safe as building an extra lane and having a permanent hard shoulder?

[George Freeman]

That is one of the precise questions that the Secretary of State is looking at. I do not want to pre-empt that work, but I absolutely accept the hon. Gentleman’s reason for asking that important question.

Highways England is constantly monitoring, and it has introduced a number of measures. This is ongoing work. It is not something we think is done and dusted; it is live as we speak. The truth is that, for anyone involved, one accident is one too many. I want to ensure that no one ever dies in this way again, and that the legacy of the people who have died is that that sort of accident, and the situation in which it occurred, cannot happen again. That is why the Secretary of State announced an evidence stocktake soon after taking office. He has called in all the evidence and data, and he is looking at a package of measures to deal with this issue, which will be announced imminently. It would be sensible if, following the debate, we quickly reconvened the all-party group on road safety. Perhaps we might go further and create a taskforce for all colleagues who are interested in this issue, so we can listen to their concerns and ensure that that work is fed directly in.

I hope my hon. Friends and colleagues on the Opposition Benches understand that I cannot pre-empt the Secretary of State’s announcement, but let me make one or two key points in response to those that were raised. It is true that the principal rationale for smart motorways is to increase capacity, reduce congestion and reduce pollution. There are environmental benefits to ensuring that we maximise the use of existing motorways rather than building new motorway capacity, but there are real issues about awareness, information, the positioning of refuges, rescue, vehicle monitoring, and the safety of vehicles re-entering the highway. All those issues have to be got right, and that is why I am responding in the way I am.

Smart motorways have increased capacity. Since we introduced the scheme, more than 1 billion journeys have been made over the 250-mile network of smart motorways. I do not want people to think this is a very small patch of malfunctioning motorway; it is extensive, and over the last 15 years, millions of people have driven up smart motorways.

Blood Cancers

Debate between Clive Betts and George Freeman

Thursday 7th July 2016 Westminster Hall

[George Freeman]

I am grateful to the hon. Gentleman for reading my mind—not for the first time—because the next paragraph in my speech is about the cancer drugs fund and the accelerated access review. His intervention gives me a moment to highlight some of the important points that colleagues have made. The hon. Gentleman, who is something of a biomedical stalker of mine on these occasions, as he acknowledged—we rarely appear in this House other than together—was right to highlight the great work that Queen’s University Belfast does on blood cancers. He spoke with great passion about his father’s experience.

My hon. Friend the Member for Erewash (Maggie Throup) spoke about her experience as a haematologist in this field and about being involved on the frontline of research. That is another example of the power of having Members with a range of career backgrounds in the House. She brings great expertise to these matters.

The hon. Member for Coventry North East (Colleen Fletcher), who is vice-chair of the all-party group, made some important points about the CDF, to which I will return, and described the experience of her husband Ian. She asked whether I would meet the Anthony Nolan Trust; I will. I have already had several meetings with the trust and will continue to meet it, and when I do, I will pick up on the issues she mentioned relating to post-transplantation care in particular.

My hon. Friend the Member for Crawley spoke powerfully about his mother’s experience and made some really important points, not least about data and the importance of our harnessing it and generating a new model of appraisal. I will pick up on the latter point when I discuss the accelerated access review.

The hon. Member for Linlithgow and East Falkirk (Martyn Day) discussed NICE and how important it is that we tackle the new landscape and make sure we are quicker and better at assessing new medicines. The hon. Member for Hackney North and Stoke Newington raised several important issues in a spirit of cross-party non-partisanship that I hugely welcome and appreciate.

I return to the cancer drugs fund. At the beginning of the previous Parliament, the Government, led by the Prime Minister, made the important commitment that we would put in place a cancer drugs fund to ensure that UK patients got access to the very latest cancer drug treatments. We did that in response to a number of high-profile cases in which NICE, applying its standard, one-size-fits-all quality-adjusted life year, had turned down cancer drugs, and patients were desperate for some hope, wanting the system to be responsive to their needs.

I am proud that we have made a total commitment of more than £1 billion to the cancer drugs fund and that we are continuing to invest each year, with more than £300 million put in this year. However, the system as it was originally set up has not proved to be sustainable, because of the pressure—inevitable pressure, in some ways, given the extraordinary explosion of our medical advances—put on it. If drug companies are turned down by NICE and there is a fund available for a post-NICE approval, the companies simply go to it and it has become over-subscribed.

NHS England has moved in the right direction by taking our funding commitment and repositioning the CDF as an early access and managed-access fund that examines more innovative drugs, ensures that they are provided to patients more quickly and makes sure that the data from that early access is allowed to inform the selection of the drugs that are adopted.

The truth is that breakthroughs in 21st century drug discovery and the rise of better targeted medicines are bringing huge benefits for patients but they also place huge pressure on our traditional models of assessment, adoption and reimbursement. With a rapidly ageing society and an explosion of new treatments, we cannot continue with the old model of one size fits all, with the NHS acting as a late procurer at a retail price of every drug. At the heart of my portfolio is a mission to unleash the power of the NHS as a research partner in bringing new drugs to market and getting a dividend—a discount—in return for that work.

We spend around £14 billion on medicines in the NHS every year and over £5.5 billion of that is spent on cancer drugs. The new generation of cancer therapies are incredibly exciting. The immunotherapies that we are seeing do not just delay death or grant patients a few extra months or years; they are cures for cancer. Those Daily Mail headlines that have been promising cures for cancers for more than 20 years are finally true. We now have cancer cures coming through, which profoundly changes the way that we will have to price drugs.

Let me say something about the accelerated access review, NICE and the CDF. At the heart of the accelerated access review is a commitment from the Government to consider whether and how we can better harness our extraordinary NHS assets as an integrated healthcare system to become a partner in the development of new therapies, so that instead of the industry treating the NHS as an increasingly pressurised retail-based consumer that struggles with this explosion of ever more expensive technology, we become a partner. Then, in return for sharing our clinical assets, for working with charities and the industry around our £1 billion-a-year National Institute for Health Research network, and for our leadership in genomics and informatics, we can pull innovation through more quickly for patients, share a data package and be the first place on Earth that companies want to come to in order to have their innovations assessed.

The accelerated access review has been examining a whole range of complex issues in this field and its report is waiting for a post-referendum slot to be published. I can assure Members that in the time that the review team has been preparing that report for publication, I have not been sitting around waiting for it; along with NHS England, I have been doing the preparatory work to be ready for it. Without in any way wanting to pre-empt the report, let me just share with colleagues some thoughts about where I think there is a huge degree of consensus between the Department of Health and NHS England on how we might be able to make some moves.

There are three key areas. First, in specialist commissioning, which deals with many rare diseases and rare cancers, the drugs are commissioned nationally through the Department of Health and NHS England. We want to see whether we can pull together that commissioning function into a more innovative procurement unit, to pull through and do some more innovative deals with industry in return for discounts—acceleration for discounts.

Secondly, we want to consider the NICE pathways through to NHS England and ask whether we can make it easier for innovators either to go through a series of much clearer NICE pathways or to go straight to NHS England and do pricing, discounting, acceleration and volume deals, as well making sure that we have an transparency and accountability framework so that people can see which parties in the ecosystem are fulfilling their mandate.

[Mr Clive Betts in the Chair]

The evidence from recent NICE approvals is encouraging. Many thousands of people have benefited from blood cancer drugs that NICE has recommended, such as bortezomib, ofatumumab and rituximab, and the evidence is that if we gather the data properly from the drugs that we approve, then we can use that as an intelligent health service to inform which drugs we adopt and pull through more quickly. If we get that right, the CDF in its reformatted position as a managed-access fund operating earlier in the system could become a powerful vehicle for an accelerated-access model of cancer drugs assessment. That will require some careful work on the NICE/NHS England framework, but we are doing that work right now, as we speak.

I will close, Mr Walker, by saying that—ah, Mr Walker has been replaced by you, Mr Betts.

[Mr Clive Betts (in the Chair)]

Observant, Minister. [Laughter.]

[George Freeman]

That was achieved in an extraordinary manoeuvre, which was so seamless I did not even notice it happening over my left shoulder.

This summer, officials in the Department will work with the accelerated access review team and NHS England to try to strike a blow for an integrated healthcare innovation economy that makes best use of our budgets. Let me put it on the record that these are substantial budgets: we have committed an extra £10 billion a year to the NHS in 2020 and at the heart of that package is an extra commitment to new drugs worth £4 billion. Those are substantial sums, but we want to make sure that those funds are spent on getting the right drugs through to the right people quickly, and in return for that acceleration we will be able to get better discounts from the industry. I am confident that by bringing the CDF together with the accelerated access review, we will be able to deal with many of the issues that colleagues have raised this afternoon.

That brings me to the end of my comments. It only remains for me to thank hon. Members for raising these issues. I hope they can rest assured that I am committed to seeing these issues through and working with them in the days, weeks, months and—who knows?—years ahead.

[Mr Clive Betts (in the Chair)]

I call Jim Shannon. You have two minutes to wind up.