Branded Medicines Voluntary Scheme and the Life Sciences Vision

Daniel Zeichner Excerpts

Wednesday 3rd May 2023 Westminster Hall

[Daniel Zeichner (Cambridge) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Sharma. I congratulate the hon. Member for Newton Abbot (Anne Marie Morris) not only on securing the debate, but on setting out in such detail and so effectively the complicated range of issues we face. I agree with much of her analysis of the problem, and although I am not sure I agree with all her proposed solutions, it is important that they are brought forward and discussed.

I represent an area of the country where life sciences, particularly research and innovation, are absolutely central to our economic prosperity. Thousands and thousands of jobs, and major investments, are at stake. Partly as a consequence of that, I have chaired the all-party parliamentary group for life sciences for a number of years, and I am grateful to a number of key players in the sector, including Steve Bates of the Bioindustry Association and Leslie Galloway of the Ethical Medicines Industry Group, for their advice in advance of the debate.

Over many months in my part of the world, I have been hearing from a range of people in the sector about their growing concern about the effect that the rebate level is having on a whole range of organisations and the threat that it poses to future investment and jobs. Indeed, the chief executive officer of the BIA has said that the clawback rate has

“gone down like a lead balloon in key global pharma boardrooms”,

and some have consequently withdrawn from the scheme.

I appreciate that this is a negotiation, but in my time talking to people in my part of the world, I have not heard this many concerns raised. Obviously, one always treats some of them with caution, but there are enough to make me think that this is a serious threat. We all agree that we want the NHS to have rapid access to, and the most consistent supply of, the most modern medicines it needs at affordable prices, and in achieving that, we can secure those vital jobs and investment. Frankly, in a complex world where medicines pricing is far from transparent and huge sums are now needed to develop new medicines, that is much easier said than done, not least because, as our knowledge and computational power and our understanding of genetics increase, making much more possible—particularly in terms of personalised treatments—the challenge of costs will only grow.

It is absolutely essential that any Government strike the right balance between securing taxpayer value and investing appropriately in our domestic life sciences industry. At the moment, many in the industry fear that this Government are cutting off their nose to spite their face. Yes, a hard bargain has been driven by the NHS—good—but there is a danger that it comes back to bite, especially at a time when we face shortages of supply. Put crudely, suppliers do not have to supply here if they are not getting the right deal.

As some see it, NHS England secures extra value by imposing commercial deals that take the prices of medicines below what NICE would consider cost-effective, even based on affordability thresholds that have not changed since they were introduced when NICE was established back in 1999. The risk is that the unintended consequence of the good deal that Governments have got drives industry away from the UK at a time when we need the life sciences sector to invest more.

This is not only about VPAS; there are other factors too. The bitter truth is that, despite the Government rightly identifying the life sciences sector as key for our future prosperity, the UK’s share of global R&D spend has decreased from 4.9% to 3.9% since 2012, and clinical trial numbers have fallen 41% since 2017. That has been a consistent message from industry over the last two years, and it has been raised consistently with Ministers.

Shockingly, the UK now has the highest rate of decline in new drug launches compared with Spain, Italy, Germany and France. If the UK ceases to be a first-launch market, patients will not have access to the latest drugs or clinical trials, we will lose the ability to compare future treatments against modern care standards and we will lose vital workforce skills that, once they are gone, will be difficult to replace. It is not just the newer patented drugs that are under threat, but generics and biosimilars too. An unintended consequence of the success of the VPAS scheme is the risk of reducing the availability of biosimilars and generics, as companies prioritise stock to higher-margin markets. A good price but no supply is not the outcome anyone is looking for.

What is to be done? I urge the Government not to dig in their heels and to at least have a sensible dialogue. I echo many of the points made by the hon. Member for Newton Abbot. Let the Government admit that there are problems: yes, our unified NHS is a remarkable resource for research, but the fragmented and complicated decision-making processes undermine that potential. It is a well-known problem. It is no good claiming that there are new regulatory opportunities post Brexit if regulators are then starved of the resources to make those opportunities real. We should recognise that the decline in clinical trials is not just an unfortunate by-product of an NHS in crisis; it is a real problem in itself, and it needs to be addressed.

The distance between how the discount levy is spent and those who make prescribing decisions just does not work. It does not incentivise behaviour, so it does not affect uptake, as the hon. Member for Newton Abbot said. Currently, there is no link between resources returned to Government and the wider life sciences vision. Addressing those points would make a difference, and I genuinely look forward to hearing the Minister’s response.

None of this is easy—it is complicated—but it is really important. Failure to deal with these problems is bad for my constituents, bad for the UK economy and bad for patients. The Government need to get out of denial mode and address the problem urgently.

--- Later in debate ---

[The Minister for Health and Secondary Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Mr Sharma. I thank my hon. Friend the Member for Newton Abbot (Anne Marie Morris) for securing this important and timely debate—I will come on to why it is so timely in a moment. I thank Members from across the House who have contributed to what has been a highly informed discussion, especially as the House is now technically in recess, as the hon. Member for Bristol South (Karin Smyth) has said.

Members will know that the current VPAS scheme is the latest in a long line of such agreements, which date back to 1957. For many years, those agreements have been at the heart of a collaborative relationship between the Government and industry. As my hon. Friend the Member for Newton Abbot says, the partnership helps to manage the affordability of medicines while, vitally, supporting our life sciences sector to deliver for UK patients and provide them with access to the most innovative and cutting-edge medicines both now and in the future.

VPAS has proven to be a powerful tool in both improving patient outcomes and supporting economic growth. Hon. Members will be aware that a key goal of VPAS, as my hon. Friend pointed out, is to ensure the sustainability of NHS finances by limiting total growth in spending on medicines. Since its inception in 2019, VPAS has driven significant improvements in patient access to cost-effective medicines. It has also ensured predictable spending growth, which is key for the NHS during a period of economic uncertainty.

I can absolutely assure hon. Members that the Government remain firmly committed to the scheme and to continuing to work with the pharmaceutical industry to create a strong, innovation-friendly environment for the development of medicines here in the United Kingdom. We set that out in our life sciences vision, as my hon. Friend said. As she also pointed out, there is only so much I can say, because it is commercially sensitive and negotiations start tomorrow, which is why this debate is so timely.

As both my hon. Friend and the hon. Member for Bristol South said, and as I have set out previously, the idea is to create a four-way win—a win for UK plc, and I will come on to why that is important; a win for our NHS, and the hon. Lady eloquently set out why that is so important; a win for patients, so that we are getting the most cutting-edge and innovative medicines to patients here in the United Kingdom first; and, importantly, a win for industry because of its importance to UK plc. As my hon. Friend the Member for Newton Abbot pointed out, life sciences falls under multiple Government Departments, which makes it complex and not the easiest thing to navigate around Government.

As my hon. Friend rightly says, life sciences falls under the Departments for Business and Trade and for Science, Innovation and Technology, is covered by us at the Department of Health and Social Care and therefore also by NHS England, and is also covered by the Treasury —ultimately, everything comes back to the Treasury. But then we have the Office for Life Sciences, which sits partially in DSIT and partially in DHSC and co-ordinates life sciences across Government.

I understand what my hon. Friend says about the important link between medicine pricing and life sciences investment in the UK, but we are in danger of simplifying a very complex situation. If it were simply down to medicine pricing, that would be a far easier argument to make to Treasury. The reality is that it is not; when we look at the investment environment in the UK, we see that it comes down to a number of things.

Yes, medicine pricing is part of that investment environment, but it also comes down to regulation, as my hon. Friend said, with MHRA and NICE, and to adoption and take-up in the NHS. Each individual trust and GP practice is autonomous. GPs, surgeons and clinicians prescribe the drugs they wish to prescribe—that is not something we centrally mandate—which means that adoption and roll-out across the NHS are not always as easy or as simple as some of the pharmaceutical companies would like it to be, solely within the gift of the Department, Ministers and clinicians at NHS England.

Clinical trials, as the hon. Member for Bristol South rightly said, are hugely important, and I will come on to talk about that later. The hon. Member for Cambridge (Daniel Zeichner) set out eloquently the importance of academia and the role it plays in inward investment into UK plc by pharmaceutical companies because of the golden triangle between London, Cambridge and Oxford—and beyond. That work is spread far more widely around the United Kingdom, but those three places are hubs, and rightly so, and I have enjoyed many a visit to see the incredible work being done there.

There are other issues, such as access to finance, R&D tax credits and, vitally, the NHS as an innovation partner, which is often forgotten. We talk about Oxford, Cambridge and some of the big university and teaching hospitals in London. Actually, the key is every district general hospital—and, in fact, I would love this to be the case for every GP practice up and down the country—being part of clinical research, and encouraging its patients to take part, because we know the impact that that would have.

I recognise the link, but it is wider than that; it is about the environment here in the UK. That is important because when I speak to UK CEOs of pharma companies —the hon. Member for Cambridge set this out—they raise not only VPAS but lots of other issues. My role, and that of my counterparts in other Government Departments —in fact, of all those involved in life sciences—is to ensure that we are giving them the tools in the arsenal to go to their global boards and make the case, as I know they want to, for investment in the United Kingdom. As the hon. Gentleman set out, there is global competition, and to some extent we are falling behind. We need to address that.

Why do life sciences matter? Why is this so important? There are three reasons. First, it is important for UK plc, as has been set out already. It is an enormous investment and part of the UK economy. Of course, it could be so much bigger. That is why it is so important that we continue to encourage life sciences investment in the UK. The second reason is its importance to patients, as the hon. Member for Bristol South set out. This is about ensuring that patients across our NHS get access to the most innovative and cutting-edge medicines that exist globally, and that we are getting UK patients access to them as quickly as, or quicker than, anywhere else.

The third reason, which the hon. Lady also touched on, is that the NHS is under considerable pressure. Some of the challenges that it faces will be addressed by more funding, and some by workforce. Those things will be very important here and now, and in the medium term. However, if we want to address the challenges that the NHS faces in the long term, that depends on genomics and gene cell therapy, and on investment in innovation and transformation around pharma, med tech, systems and AI. Ensuring that the UK is an attractive market for investment is really important to the future of the NHS, and we have world-leading academic and scientific expertise, as the hon. Member for Cambridge set out. We have a competitive tax regime, and a health system that is committed to acting as a good innovation partner. Can we do better? Yes, of course, but it is a good innovation partner. We have to unlock the transformative power of real-world data—something that the NHS is unparalleled in being able to provide.

Despite the relatively gloomy picture that my hon. Friend the Member for Newton Abbot set out, there are huge signs of hope. Take the recent investment and deals that are coming to the UK from Moderna or BioNTech. These are huge investments in UK plc and UK life sciences, which we should be very proud of. Of course, we want to see far more. We also have some exciting opportunities, as my hon. Friend set out, through the O’Shaughnessy review and our desire to massively turbocharge clinical trials in the UK. As my hon. Friend and the hon. Member for Cambridge pointed out, we are losing market share to other countries across Europe. If we look, however, at foreign direct investment, in 2021 it was £1.9 billion from 49 projects, coming in only behind the United States in terms of value—a significant increase. Furthermore, the UK life science industry raised £7 billion in equity finance. It was placed third behind only the USA and China.

I can make the case for UK life sciences—it is a strong one—but we have to do better. We have to always continue to drive forward. I understand the influence of boardroom sentiment, which the hon. Member for Cambridge set out, and that price regulation schemes such as VPAS have to be a consideration in the decision to locate investment. That is exactly why we are committed to agreeing a deal.

[Daniel Zeichner]

The Minister is giving a very thorough reply. I wonder whether he will acknowledge—I have not heard him concede this point—that the 26.7% factor is a real problem that needs to be addressed.

[Will Quince]

I thank the hon. Gentleman; I am going to come to that exact point. I want to respond to as many of the issues as possible, and—rarely for a Westminster Hall debate—we actually have a little time.

We are committed to agreeing a deal that supports a strong UK life sciences sector and drives economic growth through investment, but I recognise what my hon. Friend the Member for Newton Abbot says: we have to do far more in many other areas—clinical trials, regulation, the life sciences missions and the investment therein. There is also the ongoing work around uptake.

The hon. Member for Cambridge talked specifically about the higher VPAS percentage rates, so let me move on to those directly. Of course I understand the industry concerns about higher payment rates, but it is important to stress that those were projected when the scheme was agreed—they were agreed with industry and negotiated by the ABPI on behalf of industry. They reflect the scheme working as intended: to limit to 2% the annual growth in the sale of branded medicines within the NHS.

We are firmly committed to VPAS and to continued working with the pharmaceutical industry to create an environment that facilitates innovation and maintains the UK’s world-leading position in the life sciences sector. I remain hugely grateful to industry for its continued participation in VPAS, which has offered much-needed financial security to our NHS during a period of significant economic uncertainty.

[Daniel Zeichner]

rose—

[Will Quince]

Let me conclude the point, as I may well answer the hon. Gentleman. He has pushed me on the negotiation that we are about to start—on our mandate and where we would aim to get to. The scheme ends at the end of this year and the negotiations for the successor scheme start tomorrow. As I have mentioned, what I can say today is limited by commercial sensitivity. The negotiations will be overseen by Sir Hugh Taylor, which is hugely welcome—he brings a wealth of experience and expertise that will be of immense benefit and, I genuinely believe, will ensure that we continue to get the best outcomes for patients, the UK life sciences sector and the taxpayer.

But in response to the hon. Gentleman’s question, I should say that we are very much open to ideas about how a successor voluntary scheme should operate from 2024 onwards. I look forward to working with industry, as I know Sir Hugh does, to agree a mutually beneficial scheme that supports the sustainability of the NHS spend on branded medicines, which is critical, and also improves patient outcomes and facilitates a stronger UK life sciences industry.

[Daniel Zeichner]

This is my final intervention, I promise —I am grateful. I think I heard the Minister say that the scheme was working as intended. There is not much transparency in this process, for reasons that are perhaps understandable, but my understanding was that the current situation was not really anticipated when the scheme was drawn up and that a range of things in between have led to it. Will he clarify that point?

[Will Quince]

I am happy to. I will answer by making two points. The first is that the situation was entirely predicted. Forecasts and projections were given; whether industry believed them to be possible is another matter, but my understanding—the scheme was negotiated several years ago, prior to my time as a Minister in the Department —is that it was projected that we could have got to this point through growth. Growth has been significant, which is why it is important that we negotiate a new scheme that takes on board industry’s concerns. More broadly, we have talked a bit about medicine pricing and it is important to stress international comparisons.

Health and Wellbeing Services: East of England

Daniel Zeichner Excerpts

Wednesday 1st March 2023 Westminster Hall

[Priti Patel]

My hon. Friend is the voice of common sense on this. He will recall that we covered some of those issues in the debate we held here on, I think, 31 January. I spoke about the state being very inflexible and centralising too many resources, which need to be cascaded downwards to meet the needs of patient care.

My views on the size of the state are well known, but on this issue I think that, yet again, the centralised approach is wrong. It is simply not delivering the patient outcomes and the care that we need. We need more flexibility. ICBs are brand new, and they are finding their feet right now. We as Members of Parliament have to support them so that they can establish themselves and work with us to understand the needs of our constituents and communities. There is nothing worse than central Government funnelling cash to another centralised organisation and bureaucracy within a region, and that money going on, for example, NHS managers and bureaucracy, not the healthcare that is needed.

[Daniel Zeichner (Cambridge) (Lab)]

Let me pick up the point about NHS dentistry, the commissioning of which, I am told, is about to be transferred to the ICBs. We probably all have a pretty grim constituency experience of people trying to access NHS dentistry. Does the right hon. Lady agree that it might have been a good idea to hand that power back to local areas quite a long time ago?

[Priti Patel]

The hon. Gentleman is right. For years, I have spoken about local healthcare provision. Practitioners know best, and it is not for central structures to dictate the needs of a local community. With that, there is the issue of access to services that matter so much. Dentistry has been controversial for too long. As a result, children are not accessing dentistry in the way they should, and health outcomes are absolutely shocking and appalling, particularly in young children.

Draft Food and Feed (Miscellaneous Amendments) Regulations 2022

Daniel Zeichner Excerpts

Monday 28th November 2022 General Committees

[Daniel Zeichner (Cambridge) (Lab)]

It is a pleasure to serve once again with you in the Chair, Mr Sharma. It is also a pleasure to respond once again to a Health Minister, as I did in March when we debated the Food and Feed Safety (Miscellaneous Amendments and Transitional Provisions) Regulations 2022—a very similar title, with the same words, possibly in a different order. There is also possibly still much being done to correct the inevitable drafting errors and inconsistencies that have emerged in legislation.

Frankly, the draft regulations before the Committee today are a bit of a hotchpotch, tying up loose ends. You will be glad to hear, Mr Sharma, that I do not feel the need to comment on each and every one of them. I am not critical of the mistakes, because it is a huge and complicated task. I am always keen to praise the work of the Food Standards Agency—a notable achievement of the last Labour Government. It is one of the oddities of the changes introduced by the Conservatives that Health Ministers now do animal feed. I am sure that they are very happy to do so. [Interruption.] Or not—who knows?

Let us focus on the finer details of the draft regulations. The assessment is that the statutory instrument is a tidying-up exercise, as the Minister said. It generally maintains existing regulations and does not introduce new requirements. No concerns were raised by the Joint Committee on Statutory Instruments or the Secondary Legislation Scrutiny Committee. Therefore, Members will be happy to hear that we will not oppose the draft regulations.

I cannot resist the temptation, though, to draw Members’ attention to paragraph 7.10 of the explanatory memorandum, which reads very well. It states:

“Before Implementation Period completion day, relevant EU food and feed law provided a high level of consumer protection with regard to food and feed hygiene and safety. In particular, relevant EU food and feed law set out the general principles for the safe and hygienic production of food and feed. They also prescribed effective and proportionate controls which must be applied by food business operators and feed business operators throughout the food chain, from primary production through to the sale or supply to the final consumer. It continued to apply unchanged during the Implementation Period.”

We had a really good food safety system. What was the problem? Of course, all this statutory instrument and others do is try to ensure that it continues.

The slight problem is that the world did not stop on implementation period completion day. As paragraph 7.13 of the explanatory memorandum tactfully puts it, what emerged were

“certain difficulties, especially in relation to the approval of new, or amendment of currently authorised, substances.”

I wonder whether the Minister could elaborate on some of the difficulties posed, the potential costs that they bring, and what happens in terms of trade when we operate to different standards from those of our near neighbours. The SI addresses the administrative challenge but hardly solves the problem.

The review process is described in paragraph 7.15 of the explanatory memorandum. Could the Minister clarify the circumstances under which the Food Standards Agency will be required to review the operation and effect of the regulations? If a new extraction solvent is approved in the EU, does that automatically trigger a review? Will the FSA be required to undertake additional processes to deliver on that, and if so, has an assessment been made of whether the FSA has the capacity to undertake such duties? Perhaps the Minister will tell us that the FSA will be getting additional resource. I suspect that similar questions could be asked about a number of the other changes, but I am sure that he gets my drift.

I am also intrigued—as others may well be, if they got this far through the explanatory memorandum—by the issue of the “do not eat” pictograph referenced in paragraph 7.22, which apparently we cannot use because of uncertainty over the intellectual property rights applying to ownership of the picture. That seems somewhat bizarre. There must be many similar cases of artwork of uncertain provenance. Did we ask whether we could use it, if there was uncertainty? How much would a licence have cost? It seems an odd way to proceed. If we cannot agree on joint use of an existing symbol to promote food safety, it suggests that we have problems indeed.

I am intrigued by the need to reinstate powers to extend the transitional period for the trace presence of withdrawn GMOs. As the Minister will be aware, there is considerable interest in genetic modification, and some concern that rules on imported products are not consistent with rules governing domestic production. I wonder whether he will say a little about the scale of the issue. Just how much oilseed rape with traces of withdrawn GM products are we talking about?

I cannot resist touching on qualifying edible insects, as the Minister so delicately put it. The jokes about a previous Health Secretary are just too obvious, so I shall obviously resist them, but in the interest of full disclosure, I crunched a delicious insect bar at an event in Cambridge highlighting food futures, and very good it was too. Assuming that I am interpreting the changes correctly, I am pleased that the current rules appear to be being transposed to allow edible-insect foods to continue to be developed.

I also cannot resist quoting paragraph 10.18 of the explanatory memo. Again, not all Members may have got that far, but it bears re-reading. I particularly enjoyed this languid observation:

“The remaining 251 comments were from members who did not provide comments of substance relevant to the proposals in the consultation. They either expressed a negative view or disgust on the principle of edible insects, interpreted the consultation as an intention to mislead consumers into unknowingly buying insect products and / or linked this policy to global conspiracy theories.”

Wonderful. On that positive note, I conclude my remarks.

Draft Food and Feed Safety (Miscellaneous Amendments and Transitional Provisions) Regulations 2022

Daniel Zeichner Excerpts

Thursday 17th March 2022 General Committees

[Daniel Zeichner (Cambridge) (Lab)]

It is a pleasure to serve with you in the Chair, Ms Rees. I echo the comments made by the Minister at the beginning. I have spent many a happy hour in dialogue with the Minister for Farming, Fisheries and Food, the hon. Member for Banbury. It is always a pleasure to speak to her, and it is great to have the opportunity to hear another voice.

It is also a pleasure to deal with anything brought forward by the Food Standards Agency—a great achievement of the last Labour Government—which was established in 2000 to ensure food safety after the problems of the previous decade. Those who have followed the history of the agency will note with interest that it is a health Minister responding today. I could not possibly comment on why that might be, but many of the Food Standards Agency’s powers were moved elsewhere under the coalition Government. However, it is a fine agency.

The statutory instrument deals with a number of significant issues, although they are largely technical, as the Minister said. We absolutely agree that they need to be resolved, and you will be pleased to know, Ms Rees, that we will not oppose the SI. Some of the regulations touch on the very challenging issues posed by the Northern Ireland protocol, and I am grateful to the Minister for his clear explanations in spelling them out. I am also very impressed by the explanation in the explanatory memorandum. Those of us who are now becoming aficionados of statutory instruments will note the different styles from different Departments, and I was delighted to hear the Food Standards Agency’s positive account of the current set-up. In fact, I am so impressed that I will read it into the record. Paragraph 7.4 states:

“Before IP completion day, relevant EU food and feed law provided a high level of consumer protection with regard to food and feed hygiene and safety. In particular, relevant EU food and feed law set out the general principles for the safe and hygienic production of food and feed. They also prescribed effective and proportionate controls which must be applied by food business operators and feed business operators throughout the food chain, from primary production through to the sale or supply to the final consumer.”

That is absolutely right, and it is a very good system.

I hope that one or two of those in DEFRA who, as I have been saying to the hon. Member for Banbury, are a bit more negative about it will note the reasoned and sensible approach that the Food Standards Agency takes. If we look at paragraphs 7.7 and 7.9, however, where the first two items referred to by the Minister are set out in detail, I have to ask whether this has been a paper exercise in which potential problems have been identified, or whether any of the situations that could have occurred actually occurred. If they have occurred, how have they been dealt with? Will the Minister tell us whether any such situations have actually occurred, and explain how they were dealt with?

I welcome the clarification that the GM and feed additive authorisations will be done through an SI. Will the Minister clarify which procedure is to be used, whether negative or affirmative? There is considerable public interest in some of this. Will he also spell out how that sits with the Government’s longer-term strategy for GM products, given the recent statutory instrument that changed some of the rules on research and gene-edited crops?

Another issue is that of labelling and the length of any grace period as existing labels are used up, which paragraph 7.11 states will be through to 30 September. The Minister may or may not be aware of the many issues facing the food production sector at the moment, but labelling is one of them, ironically—there is a real shortage of labels, frankly, and that is a significant problem, as we can all imagine. An article in The Grocer last week highlighted that that is one of the most pressing issues. I wonder whether that date is still considered appropriate in these circumstances, not least because some of the consultations referred to go back a long way. Back in 2018, the world was a very different place. Much has changed since then.

I was struck by the consultations—nerd that I am, I’m afraid I read some of them, and they make interesting reading. One of the complaints or observations by the sector, referenced a little in the explanatory memorandum, was about the expectation that the changes to the regulations could be read through in under an hour, with businesses, regulatory agencies and councils able to work out how to apply the changes to their organisations. Frankly, a lot of people thought that that was optimistic. I wonder whether any further thought has been given to it.

Some of the observations, although from a while ago, were quite prescient. The National Pig Association, the National Farmers Union and the Food and Drink Federation all raised questions. In particular, the NFU asked about the relationship with the European Food Safety Authority. My noble Friend in the other place, Lord Rooker, has frequently asked that question. Back in the consultation, the NFU said:

“The NFU is also concerned that the approach the government plans to take depends on the UK’s relationship with EFSA. We would very much support close collaboration with EFSA but we need reassurance that this will happen…Given the trade flows between UK and EU, it is essential that the exchange of information and collaboration…on the same terms is achieved.”

I could make many more points, Ms Rees, but you will be glad that I am not going to. I have raised the ones I wanted to explore this morning. If the Minister could comment briefly on the relationship with the EFSA in the context of the draft statutory instrument, it would be much appreciated.

Oral Answers to Questions

Daniel Zeichner Excerpts

Tuesday 19th October 2021 Commons Chamber

[Sajid Javid]

Again, my hon. Friend is right to raise this issue. As we have just heard from other hon. Members, there is a real issue with dentistry across England, including in North Yorkshire, and we know how the pandemic has had an impact on that. Dentists have tried to do the best they can in those circumstances. The changes we are making to infection prevention and control will help. We are looking at further measures, and I understand that my hon. Friend will be meeting the Minister shortly to discuss his issues in North Yorkshire carefully.

[Daniel Zeichner (Cambridge) (Lab)]

2. What recent estimate he has made of the size of backlogs in cancer diagnosis and treatment.

[The Secretary of State for Health and Social Care (Sajid Javid)]

The number of people waiting longer than 62 days for treatment following an urgent referral for suspected cancer in England has come down considerably, from 35,000 people in May 2020 to about 19,000 people. The NHS is putting in place extra capacity to diagnose and treat cancer patients, with the aim of clearing the cancer backlog of patients waiting over 62 days from referral to first treatment by the end of March 2022.

[Daniel Zeichner]

To do that, we are going to need healthy NHS staff. I was alarmed to hear Cambridgeshire’s director of public health last week talking about the sheer scale of covid ripping through the school population and then into the parental cohort, many of whom, of course, will be working in the NHS. Peterborough currently has the highest number of cases it has had at any time during the pandemic. So what is the Government’s plan to keep NHS staff healthy, in order to allow them to tackle that alarming cancer backlog?

[Sajid Javid]

First, let me say that NHS staff have done a phenomenal job throughout the pandemic in helping patients with cancer or any other illness. A comprehensive plan of support has been in put in place, with this Department working with our NHS colleagues carefully to provide, for example, advice and help. Extra mental health support has been provided as well, and we are looking to see what more we can do.

Covid-19 Vaccine Damage Bill

Daniel Zeichner Excerpts

Friday 10th September 2021 Commons Chamber

[Sir Christopher Chope]

I do not think that Madam Deputy Speaker is saying anything. I am saying that it was added to the scheme, but, to all intents and purposes, it was just a gesture. In the substance of it, people have now started applying under the Act for compensation and none of those cases has been dealt with. No decisions have been made in any of those cases. No decisions have been made in any of those cases. There is now a worrying Government response to a petition that reflects what is in my Bill, calling for reform to the Vaccine Damage Payments Act 1979

“to improve support for those harmed by covid-19 vaccines”.

You may remember, Madam Deputy Speaker, that the Pearson commission found that those injured as a result of vaccination should have access to financial support and that that was the background to the 1979 Act. However, the Act makes provision of a maximum payment of £120,000 together with a threshold of 60% disablement. As a result, fewer than 2% of applications are successful. My Bill calls for the Government to set up a judge-led inquiry into the issues raised.

The petition says:

“Reforming the VDPA will maintain vaccine confidence and provide urgent support for those injured/bereaved through covid-19 vaccination.”

What did the Department say in response to the petition? As you know, Madam Deputy Speaker, when a petition has gathered more than 10,000, signatures, that triggers a Government response—we do not get a debate in the House until there are 100,000 signatures. The response, dated 5 August, says:

“The Government has a robust system to monitor potential side effects of the COVID-19 vaccine and has added the vaccine to the VDPS. We will consider further action as more evidence becomes available.”

It goes on to tell us what we already know about the 1979 Act. It then says:

“Whilst understanding the desire and need to move forward rapidly with processing these claims, it is important to have an established evidence base around causational links between the vaccine and potential side effects. Not doing so risks claims being declined in error based on a lack of evidence, disadvantaging applicants.”

However, we already have a lot of evidence that people have suffered damage, if not death, as a result of these vaccinations. A recent coroner’s report on somebody—I think in the north of England—came to the verdict was that they had died as a direct result of receiving the covid-19 vaccine. The response continues:

“More widely, the Government is currently looking at how it can improve the operational aspects of the VDPS to better meet the additional demand created by the inclusion of the COVID-19 vaccine and improve the customer experience. Once more is known about the possible links between the vaccine and potential side effects, it will be considered whether a wider review of the VDPS is needed.”

My Bill answers that question by saying that we need such a review now.

[Daniel Zeichner (Cambridge) (Lab)]

Fridays are a wonderful thing in this place. The hon. Member calls for a judge-led inquiry. I quite understand the importance of the issue, but many believe there should be a judge-led inquiry into many aspects of what has happened on covid and will wonder why this issue should get preference over others. Will he give his thoughts on how he would explain to care workers in care homes, for instance, why their concerns should not be considered at the same time as these important concerns?

[Sir Christopher Chope]

On the requirement that this House has made that all care workers in care homes should be vaccinated even if they have a genuine desire not to be—they may be fearful of the consequences, although consequences are seen in only a minority of cases—it should surely be for the judgment of each individual whether they will take the risk of having a vaccination or not. Obviously we know that, even if people are vaccinated, it does not mean that they are immune from covid-19, and it certainly does not mean that they are incapable of transmitting it to somebody else. Those issues need to be weighed up.

To go back to the hon. Gentleman’s challenge, he seems to be suggesting that those hapless families—10,000 of them, or maybe more—who have suffered real, serious damage as a result of doing the right thing should be left hanging around for years wondering whether they will be eligible for any compensation. That is totally the wrong message. The Government should be sending the message that, “If you do the right thing, you will be looked after by the Government if something goes wrong.” In a sense, that is what we do with the military covenant. People enter the armed forces of our country and, if something goes wrong, they expect the Government to look after them, and we do. We should be doing exactly the same for those who have suffered vaccine damage, instead of talking around the subject in the way that the Minister’s reply to the petition suggests is Government policy.

Health and Care Bill

Daniel Zeichner Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Daniel Zeichner (Cambridge) (Lab)]

Anything that starts to undo the damage done by the 2012 Act is welcome. Some of the Bill reflects what has been the reality on the ground for some years: our local health services have indeed been ignoring the competition elements. I applaud them for it; they sensibly recognised that the only way the NHS could cope would be to co-operate, not compete.

I put on record my thanks to those leading our health and care system in Cambridgeshire in recent years. They were brave—they should not have had to break the law to deliver the services that our people needed. I also give heartfelt thanks to all the staff, medical and non-medical, who go above and beyond. What they do not need at the moment, on top of everything else, is the uncertainty that now encompasses them.

The reason why those people were in that difficult position is what makes me oppose the Bill: I will never trust the Conservatives not to try to privatise the NHS. That is based on long experience, because Cambridgeshire was the test bed for many of the 2012 reforms, which of course were driven by Lord Lansley, the then MP for South Cambridgeshire. Long before I came to this place, I was working with other campaigners, particularly Unison, Unite and GMB colleagues, to tackle what felt like an endless onslaught.

I remember arguing over the lifting of the private patient cap. The then chief executive of Addenbrooke’s Hospital told me at an annual general meeting that where he came from, people were very relaxed about private healthcare. For years, Addenbrooke’s had land allocated for a private hospital, and the chief executive admitted that the future business model was to seek to bring patients from across the world.

The then chief exec of the Royal Papworth Hospital was on record as wanting to expand private care from 5% to 15%. Nearby Hinchingbrooke hospital was run as a private outfit by Circle Health, until it handed it back because it could not make it work; Circle was then run by Ali Parsa, now CEO of Babylon Health, whose app was so brazenly promoted by the former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock). Then there was the UnitingCare fiasco, which I spoke endlessly about in this House: an £800 million five-year contract under which older people’s services were, effectively, privatised, until it collapsed in a huge waste of time, effort and public money. So there is form, and that is why I will always oppose this legislation.

There are other concerns, but time is limited, so I will cite just a couple. The British Association of Social Workers has highlighted the removal of social work assessment prior to hospital discharges. It is right to do so. The relationship between hospitals and some care homes has long been far too close, in my view—frankly, at times it borders on the corrupt. There is pressure to discharge too quickly, so the last thing we need to do is remove professional assessment. I am also concerned about clause 80 on data sharing, because I do not trust the Government on that either.

We have a wonderful NHS. It needs support, not reorganisation, but all past experience and evidence tells me that the Tories will always want to find a way of making money out of it. We will always try to stop them, because that is not what the NHS is about.

Oral Answers to Questions

Daniel Zeichner Excerpts

Tuesday 13th July 2021 Commons Chamber

[Daniel Zeichner (Cambridge) (Lab)]

What progress he has made on consultations on the General Practice Data for Planning and Research roll-out.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

We are committed to being transparent about the collection and use of data. We paused the implementation of GP data for planning and research services, and we have had productive discussions with the Royal College of General Practitioners, the British Medical Association, health charities and others. We have listened to the concerns and we will respond to them. We will continue to listen and we will take our time. We will show patients and clinicians why they can have full trust and confidence in the programme, where data will only be accessed through a secure environment with the oversight of the Information Commissioner’s Office and the National Data Guardian.

UK Rare Diseases Framework

Daniel Zeichner Excerpts

Wednesday 24th March 2021 Westminster Hall

[Daniel Zeichner (Cambridge) (Lab) [V]]

I, too, congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing the debate. I chair the all-party parliamentary group on life sciences and want to raise a couple of wider points. I am grateful to the Association of the British Pharmaceutical Industry and the UK Bioindustry Association for advice.

We are all familiar with the figure of Sir John Bell on our television screens, but in the current circumstances would the Minister tell us a little about the status of the life sciences industrial strategy and sector deal? It seems that the industrial strategy has gone by the wayside. What is going on? Will she also tell us how the various initiatives, including the NICE methods review, the innovative medicines fund and the recently published commercial medicines framework will work together to support access to medicines for rare diseases?

There has been a long-running issue around the NICE process review in relation to the single technology appraisal programme, which many feel is not very suited to the specialised medicines world. It led to the highly specialised technologies programme, but there is a continuing gap between the two, and perhaps she can shed some light on that.

Professor Lucy Raymond was professor of medical genetics and neurodevelopment at the department of medical genetics in Cambridge, and has welcomed me on Rare Disease Day in previous years. She made a couple of important points, saying that despite the welcome work done by the 100,000 genomes project at such places as the Wellcome Sanger Institute, there are still long delays, and testing is limited by resources and NHS England funding. Secondly, there is the question of making sure there is sufficient access to clinical trials. Professor Raymond suggests that as we have a limited number of nationally funded genomic laboratories, it could be possible to introduce a statutory obligation to notify, which would produce a bigger group for clinical trials.

Finally, on the question of our relationship with the European Union, what progress has been made on developing a rare disease trial protocol?

Covid-19 Update

Daniel Zeichner Excerpts

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

My hon. Friend raises a very important point: free the leisure centres! Many are being used as vaccination centres now, but, like her, I look forward to the day when they can be used for the purpose for which they were built—as leisure centres. It is important that, should we need a continued vaccination programme, for instance, over the summer and into the autumn, as seems likely, we will have to move to more permanent places or places that are free to be used as vaccination centres over that period. In fact, that has already started to happen. We have already started to move some of our testing and vaccination centres to more semi-permanent sites to free up the original sites that we started with, because we needed things to move incredibly quickly. That is an important consideration. Frankly, it is best done as close to the local area as possible, so it is right that I do not get involved in each individual one. I am absolutely certain that the NHS in Wolverhampton is far better placed to make those sorts of decisions than I am from this Dispatch Box, but I hope that it will keep my hon. Friend informed.

[Daniel Zeichner (Cambridge) (Lab) [V]]

I am afraid that “data not dates” clearly has not worked, because people have quite understandably just focused on the dates. The spring sunshine at the weekend meant that in lovely places such as Cambridge it was very busy. Are the Government now going to make a precautionary adjustment or, with hospital numbers still so high, take a chance and risk running the NHS into the ground?

[Matt Hancock]

No.