Coronavirus Response
James Davies Excerpts(4 years, 4 months ago)
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Matt Hancock
Yes, I like the new Barry—he is like the old Barry, before he got very cross with me over Brexit. Welcome back; it is really nice to see you. If I may, I will make this clinical point, which I normally avoid: it is also really good for your blood pressure.
We have been working really hard with Huddersfield and the local authorities in the hon. Gentleman’s part of the world to bring the virus under control. It has been a real team effort and an example of how things should be done working together. I appreciate the hon. Gentleman’s words on that. I hope that the whole local team will see that this is a big cross-party effort and that there is not some sort of fake attempt to create division. This is everybody working together to try to tackle this virus, and that is how it should be.
On the latter point, I agree with the hon. Gentleman very strongly about tackling the anti-vax movement, and he is right to raise that. He is also right that this is not just about the covid vaccine, but the flu vaccine too. We are moving to make sure that a far higher proportion of people in the NHS get the flu vaccine. This winter, the expectation will be that every single person who works in the NHS will get the flu vaccine, unless there is a very good, essentially clinical, reason. Making that happen is a big part of the work I am doing with Simon Stevens and the NHS leadership, to drive that through.
Dr James Davies (Vale of Clwyd) (Con)
I thank my right hon. Friend for his statement. He referred to an additional £3 billion for the NHS to help keep the temporary Nightingale hospitals open over the winter, should they be needed, and to keep non-covid sites available for routine healthcare. Will he confirm how that funding relates to Wales?
Coronavirus Update
James Davies Excerpts(4 years, 4 months ago)
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Matt Hancock
We are looking at all the evidence and take very seriously all the academic, professional and medical studies into the pandemic and the response to it, both here and around the world.
Dr James Davies (Vale of Clwyd) (Con)
Further to today’s announcement regarding the mandatory wearing of face masks in shops, is it anticipated that similar may yet need to apply in pubs and bars?
Oral Answers to Questions
James Davies Excerpts(4 years, 5 months ago)
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Lilian Greenwood (Nottingham South) (Lab)
Dr James Davies (Vale of Clwyd) (Con)
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
Matt Hancock
Obviously, as soon as possible. I agree very strongly with the hon. Lady about the importance of contact tracing—the Test and Trace programme is one of the largest of its kind—to ensure that, as we manage to lift national measures, which we can because the disease is clearly under control and the number of cases is coming down, we can then respond through local action.
Dr James Davies
NHS Test and Trace will play an important part in our continued fight against covid-19, but efficient co-ordination across Great Britain will be vital to its success. What steps has my right hon. Friend taken to ensure effective joint working between England, Wales and Scotland?
Matt Hancock
That is an incredibly important question. Of course, I would add Northern Ireland to that group. We have regular meetings. I have a weekly call with my counterparts in the devolved Governments. Of course, the devolved Governments have a huge role to play in this. I will give whatever support I can to help the Welsh Government to make sure that they can deliver contact tracing, and indeed the wider testing programme, as well as possible.
Covid-19 Response
James Davies Excerpts(4 years, 6 months ago)
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Dr James Davies (Vale of Clwyd) (Con) [V]
It is widely believed that the impact of covid-19 in the UK has been greater because of high levels of obesity. Does my right hon. Friend agree that we must do more to tackle the causes of obesity in our society?
Matt Hancock
Yes. It is true that the early evidence shows that obesity is a major factor in covid-19’s impact on an individual. One early study by Dr Ben Goldacre implied that serious obesity is one of the greatest factors, after age. We must make sure that we tackle obesity across the nation, and I very much look forward to working with the Prime Minister to bring forward plans to tackle obesity.
If I may, cheekily, Mr Speaker, I wish to thank all community first responders for the work that they are doing, because I know that my hon. Friend the Member for Brigg and Goole (Andrew Percy) wanted to ask about them.
Covid-19 Response
James Davies Excerpts(4 years, 7 months ago)
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Matt Hancock
The development of testing has been at pace throughout this crisis, entirely contrary to the story told by the right hon. Gentleman. We were one of the first countries in the world to develop a test. We rapidly increased the number of tests, from 2,000 at the start of March to 10,000 during March—a fivefold increase—and it is now going up further. This is an area where we had our foot on the gas all the way through, because it is incredibly important.
Dr James Davies (Vale of Clwyd) (Con) [V]
I am grateful to the Secretary of State for his statement. Would he kindly update the House on the provision of a new covid testing site in north Wales and on the UK Government’s role in delivering it, in the context of devolution?
Matt Hancock
Testing is an area with UK and devolved responsibilities. The drive-through testing sites are being provided right across the UK under a programme being driven by the UK Government with the support of the devolved authorities. It is incredibly important that we make testing available in north Wales, as it is right across the country, so that people can access those tests, as my hon. Friend said. I should also mention the home testing, which will be available through the post. Especially in more rural areas, such as his constituency, that might be one of the most effective ways of people accessing testing.
Wuhan Coronavirus
James Davies Excerpts(4 years, 9 months ago)
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Matt Hancock
That is a very good point. People should follow the clinical advice for the symptoms they have, with there being, of course, a much higher risk if they have travelled to one of the affected areas. In that case, they should call 111 and present, and have the test. The testing is available precisely to distinguish the difference, because it is not reasonable to ask ordinary members of the public to know the difference between an old coronavirus and the novel coronavirus, or indeed, between flu and coronavirus.
Dr James Davies (Vale of Clwyd) (Con)
Will my right hon. Friend provide an update on the likely timescales for the development of a vaccine for Wuhan coronavirus, and on Britain’s contribution to that?
Matt Hancock
We have put £40 million into the global and domestic efforts to find a vaccine, and the work got under way fast. That work is progressing, but it takes time not just to develop a vaccine, but to ensure that it is assured and safe to use. It is in the nature of these things—because of incubation periods and the nature of the science—that it does take time.
Oral Answers to Questions
James Davies Excerpts(4 years, 10 months ago)
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Dr James Davies (Vale of Clwyd) (Con)
Matt Hancock
I worry about the delivery of health services to people in Wales. Although this issue is devolved, I am the UK Health Minister, and my hon. Friend is right to raise that issue for his constituents. The number of people waiting more than one year in Wales is over 4,000. In England, despite the much larger population, it is only just over 1,000. The Welsh NHS, frankly, is an advert for why people should not want the Labour party running the NHS.
Health and Social Care
James Davies Excerpts(4 years, 10 months ago)
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Dr James Davies (Vale of Clwyd) (Con)
It is a pleasure to follow the new hon. Member for East Dunbartonshire (Amy Callaghan). Indeed, I congratulate her on her maiden speech. She spoke with striking personal elements as well as a very clear affection for her constituency. She clearly has strong views, and in that respect she evidently follows on in the long line of strong women representing her area, so I congratulate her wholeheartedly.
It is a privilege to be back here again representing my home constituency of the Vale of Clwyd following an unwelcome and enforced couple of years away. I am, of course, generously termed a retread.
I must start by placing on record my true thanks to all my constituents who voted for me, many of whom voted for my party for the first time ever. It is my ambition to live up to their hopes and aspirations, as well as to the hopes and aspirations of everybody else who did not vote for me. As I did in 2015, I pay tribute to my predecessor, Chris Ruane, who was well respected and represented the constituency very ably for more than 20 years in total.
On the doorsteps in November and December, there was no bigger domestic issue than health. I must declare an interest, as I am an NHS doctor and I am also married to an NHS nurse. Between 2017 and 2019, I worked full-time as a GP in my constituency in Rhyl and in other parts of north-east Wales and west Cheshire. This has given me a unique insight into the state of the NHS in north Wales and further afield. Health matters were transferred to Cardiff, almost in their entirety, 20 years ago. That includes the organisation, structure and basic terms of functioning of the NHS. The reality, though, is that there is still much confusion among the electorate about where powers lie, and my inbox has been inundated with NHS issues since my re-election.
The north Wales health board—the Betsi Cadwaladr University Health Board—has been in special measures for more than four and a half years, which my constituents and I find totally unacceptable. As yet, there is still no evidence of a turnaround, and my constituents are being let down by a systemic failure in the north Wales NHS. I am extremely limited for time today due to the number of speakers, but in future debates I hope to expand in detail on the issues that I have come across over the last two years in particular. Let me just emphasise that comparable and meaningful data to highlight the extent of this state of affairs is often lacking—if I am honest, I think that may be deliberate—especially given that one of the benefits of devolution was meant to be that we could compare performance of different policies across different parts of the UK. I will expand on the causes behind the problems that I have come across on another occasion, but let me say now that workforce is a key issue, including poor recruitment and retention of staff.
To conclude—in the 40 seconds or so I have left—I have outlined not only interesting statistics, but sadly an indication of unnecessary loss of life and of harm to real patients. At the very least, there is a need for UK-wide patient safety mechanisms and rigorous inspection regimes, underpinned by comparable statistical data on performance and outcomes. I urge the Secretary of State seriously to consider that when progressing the initiatives outlined in the Queen’s Speech.
Madam Deputy Speaker (Dame Rosie Winterton)
It is a great pleasure to call Munira Wilson to make her maiden speech.
Mental Health and NHS Performance
James Davies Excerpts(7 years, 10 months ago)
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Mr Hunt
I am more than happy to meet Mrs Hardy, but ahead of that I would like to look at the particular issue of why she has had to wait for so long. The hon. Gentleman put it very eloquently, and she put it very eloquently, and we owe a huge debt to such people. What she has described with her 19-year-old daughter’s treatment is just not satisfactory: it is not good enough. That is why the Prime Minister talked this morning about the injustice of having to wait so long for treatment, and that is exactly what we are trying to put right.
Dr James Davies (Vale of Clwyd) (Con)
The House of Commons Library has calculated that the real-terms increase in health-related spending between 2010 and 2016 was 9.4% in England, yet it was zero in Wales. Not only are A&E waiting times consistently longer in Wales than in England, but waiting times for routine procedures can be as much as two and a half times longer in Wales. I regularly see constituents in tears who are waiting well in excess of a year for hip operations. Does the Secretary of State agree that the Labour party must start to acknowledge the challenges facing the NHS in Wales and accept responsibility for them? [Interruption.]
Health Service Medical Supplies (Costs) Bill
James Davies ExcerptsMonday 24th October 2016
(8 years, 1 month ago)
Commons ChamberRead Full debate Health Service Medical Supplies (Costs) Act 2017 View all Health Service Medical Supplies (Costs) Act 2017 Debates Read Hansard Text Read Debate Ministerial Extracts
Dr James Davies (Vale of Clwyd) (Con)
It is a pleasure to speak in support of the Bill, which affects my constituents in north Wales as it applies UK-wide. It is an example of the Government responding reasonably quickly to issues that have been brought to their attention, and they deserve some credit for that.
My principal reason for supporting the Bill relates to the vast increase in the costs of certain off-patent drugs, as we have heard today, and its impact. I first had contact with constituents in June about a loophole in existing regulations resulting in some old generics being hiked up in price by up to 12,000% over the course of eight years. This followed the investigation in The Times in which 50 drugs were identified as costing the NHS about £262 million a year. To put that into perspective, it is equivalent to 7,000 junior doctors. I believe that there have not been similar price increases in mainland Europe, interestingly, which tends to suggest that we have some failures in our regulations. We also discussed this matter in the Health Committee and we saw evidence of correspondence that had highlighted it for at least one year.
We should not refer just to costs, of course. There are also big impacts on patients when their drugs are withdrawn. That issue hit home when I met a constituent, Eira Roche, at one of my constituency surgeries in the summer. She has given me permission to talk about her story. She was diagnosed with hypothyroidism—an underactive thyroid—in 2006. She had the typical symptoms of weight gain, thinning hair and brittle nails. She was tired all the time, she had pain all over and she had a low mood. She was prescribed T4—thyroxine—which is the usual treatment in such circumstances. She was also given a cocktail of other drugs, because the T4 simply did not work. She was on quite strong medication for an extended period.
Eira saw her endocrinologist at Glan Clwyd hospital in my constituency in 2014, and he started her on a drug called T3—liothyronine—which she describes as an absolute revelation. In fact, she said that she was much better than she had been for years: her brain fog lifted and her energy levels soared. When she tried to reduce the dose of the drug, she found that her symptoms began to return and she had to have some time off work. She is now a teaching assistant and caretaker at Ysgol Bodfari.
The drug Eira is taking, liothyronine, was acquired from GlaxoSmithKline in 1992 by Mercury Pharma, which is now part of AMCo. To put the costs into perspective, a packet of the drug cost £34.65 in 2011, but this year the cost is £258.20, which is a 645% increase. Shockingly enough, that increase is relatively insignificant compared with some other examples, but it is still quite significant. I understand that drugs costing £3.4 million a year in 2010 now cost the NHS over £20 million a year.
My local health board, Betsi Cadwaladr University Health Board, is understandably concerned, as are other parts of the NHS in the UK, and it has looked at withdrawing the drug. That makes Eira feel very anxious. She is worried about the impact on her colleagues if she is unable to work, and about the impact on her pupils with special educational needs and other needs. She also has two children of her own. The Department of Health has asked the Competition and Markets Authority to investigate this issue. That may or may not result in a good outcome, but it is not a sustainable way forward: it will not close the loophole or stop the same thing happening again. That is one reason why we need this Bill.
The generics market is generally competitive, with fair prices for all. I believe it accounts for £4 billion of the £15.2 billion spent by the NHS on drugs per annum. However, the £4 billion figure represents a 20% rise during the past five years. There is a statutory system, which can in theory control the prices of both branded and generic drugs, but there is the loophole I have mentioned.
The loophole involves old generics that are usually available via one manufacturer or supplier that also happens to market branded drugs and is a member of the voluntary pharmaceutical price regulation scheme in relation to them. Their membership of the PPRS means that, under existing legislation, they cannot currently be subject to the statutory scheme, even for their generic drugs. There are concerns that this loophole has been actively exploited by some. Indeed, it has been a deliberate business model to purchase off-patent medicines for which there are no competitor manufacturers—in other words, where there is no competition. Hon. Members might ask why other drug companies have not sought to manufacture such drugs if they are sold in such large quantities. Introducing new competition is not always feasible, however, because of the time it takes to obtain a rival licence from the Medicines and Healthcare Products Regulatory Agency, and because the size of the market is often small once such medications are produced and the manufacturing process is often difficult.
I support a change in the primary legislation—the National Health Service Act 2006—to allow the Government to consult on and bring forward the enforcement of statutory controls on all generic drugs to require companies, if necessary, to reduce the price of the drugs or to impose other controls. This amounts to an extension of the existing deterrent powers that the Secretary of State has not yet used to direct the prices of drugs that already fall under the statutory scheme. Assuming the Bill receives Royal Assent early in 2017, we would need investigations and discussions with the companies concerned where issues have been raised. It is important to be fair not only to the taxpayer but to such companies. If not, there remains the ultimate risk that such products are taken off market.
Where does that leave my constituent, Eira? I am sure she is hoping that the Bill will go through. She will be looking to the CMA to come forward with some good news. She may be tempted to purchase the liothyronine from abroad or online. Interim prescriptions to allow patients like her to continue to receive her prescription need to be considered. If the Government feel that the drugs can be acquired at a much better rate—from abroad, for instance—such people would very much appreciate assistance in doing so. For everyone, the routine and systematic monitoring of drug costs will clearly be important.
I will briefly mention the two other principal elements of the Bill. The first is the proposed change to the statutory scheme. In autumn 2015, the Secretary of State issued a statutory consultation on strengthening the statutory scheme. The Bill proposes to bring the statutory scheme in line with the voluntary 2014 PPRS for all manufacturers or suppliers that are not PPRS members. There are 166 companies currently represented in the PPRA, and £8 billion is currently spent through that mechanism. Interestingly, £647 million is brought back to the taxpayer each year when the agreed cap is exceeded. There are just 17 companies in the statutory scheme, through which £l billion is spent. There is evidence of companies switching from the voluntary to the statutory scheme for financial reasons, meaning that there is an £88 million annual loss to the taxpayer. It should be borne in mind that these companies are mostly small and non-UK domiciled ones.
Changes to the statutory scheme will require companies to make payments back to the Department of Health based on their level of sales to the NHS—this can be in addition to other mechanisms—whereas the existing statutory scheme operates via a cut to the published list price, which is currently set at 15%. The existing statutory scheme therefore brings in less money, but also results in inequity to companies, risks to supply and uncertainty of financial outcomes for complex reasons that, fortunately for hon. Members, I will not go into. The Bill also proposes new penalties for non-compliance and for the recovery of payments owed through the courts. Ultimately, the Bill creates a more level playing field between companies in the two schemes. It merely extends what is in place for the vast majority of companies, so it is not in any way unreasonable. I do not believe there should be major concerns with regard to the impact on research and investment.
The other element of the Bill involves information powers. The Bill brings together the information requirements for NHS medicines and other supplies in one place in the 2006 Act. It will enable the Government to make regulations to obtain information on the sales and purchases of medicines and other medical supplies from all parts of the supply chain—from the manufacturer to distribution to the pharmacy—for defined purposes. This will improve the data that inform reimbursement arrangements for community pharmacies and GP practices. We hope that it will help to ensure value for money for the NHS.
These are positive proposals, but it is important that they are not overbearing on the companies concerned. In particular, I want to make the case for medical technology and devices businesses, which have not been subject to such data collection in the past. The Secretary of State has given us some reassurances about that today, but we need to recognise that a large proportion of them—99%, I think—are small or medium-sized enterprises, so we need to work with the industry to develop appropriate regulations. We need to avoid onerous and certainly routine data collection beyond what is already required by Her Majesty’s Revenue and Customs.
In summary, I support the principles of the Bill—in fact, the Association of the British Pharmaceutical Industry largely supports the Bill as well—but the detail will be subject to consultation during 2017. I look forward to scrutinising the progress of the Bill over the coming months.