Antibiotic Resistance

Jamie Reed Excerpts

Wednesday 15th October 2014 Westminster Hall

[Mr Jamie Reed (Copeland) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Chope. I also extend my thanks to the hon. Member for York Outer (Julian Sturdy) for securing this critical debate. He has done a great deal of work on raising the profile of antimicrobial resistance since he entered this place in 2010. Like him, and every other Member who has spoken today, I understand the issues at stake if we do not do everything within our power to tackle this threat. As well as being a shadow Health Minister, I am also chair of the all-party parliamentary group on antibiotics, which is co-chaired by the hon. Member for Richmond Park (Zac Goldsmith), who has just made a superb contribution to the debate. The hon. Member for York Outer did an excellent job in setting out the scale of the challenge that we face today.

The APPG on antibiotics was formed in June 2013 specifically to raise the profile of antibiotic resistance. Through working with key stakeholders and experts on the issue, we hope to build a cross-party consensus on tackling the threat of AMR. Before moving on, I want to praise the work of Professor Laura Piddock and the British Society for Antimicrobial Chemotherapy. That organisation works tirelessly to highlight the threat of antibiotic resistance; without it, the APPG might not even exist.

In the foreword to the document “UK Five Year Antimicrobial Resistance Strategy 2013 to 2018”, Dame Sally Davies gave a concise explanation of the scale of the challenge that we currently face:

“There are few public health issues of greater importance than antimicrobial resistance…in terms of impact on society. This problem is not restricted to the UK. It concerns the entire world and requires action at local, national and global level. AMR cannot be eradicated but a multi-disciplinary approach involving a wide range of partners will limit the risk of AMR and minimise its impact for health, now and in the future.

The harsh reality is that infections are increasingly developing that cannot be treated. The rapid spread of multi-drug resistant bacteria means that we could be close to reaching a point where we may not be able to prevent or treat everyday infections or diseases.”

Her sentiments and judgment have been echoed by scientist after scientist and medical professional after medical professional. Dame Sally Davies must be commended on her commitment and work on this issue—I am pleased so many hon. Members have recognised that today—and her leadership should be applauded. The Government must take heed of what she says and take the actions she recommends.

A report published on 10 October by Public Health England, “English surveillance programme for antimicrobial utilisation and resistance”, highlights that the problem is already real now and, as Members have observed today, is getting worse. Antibiotic prescriptions are rising—they increased by 6% in the past three years alone. At the same time, resistant bacterial infections are also on the rise. Resistant E. coli infections have risen by 12% since 2010. Dr Susan Hopkins of Public Health England told the BBC recently:

“We know that less than 1% of bacteria are extremely multi-drug resistant at the moment…But in countries like India they are approaching 10% to 20% of individuals they are not able to treat effectively with the antibiotics.”

The threat is real and we all agree that something must be done; inaction cannot be tolerated.

The Science and Technology Committee published its report, “Ensuring access to working antimicrobials”, on 7 July. At Health questions on 15 July, responding to the hon. Member for York Outer, the Minister said that the Government would publish their response to that report in September. We are now into October, so I hope she will explain when that response will be ready.

Government action is overdue. With that in mind, I would be grateful if the Minister would update Members on the progress made towards the three strategic aims and the seven key areas for future action as prescribed in the chief medical officer’s report on the five-year antimicrobial resistance strategy. The three aims were to improve the knowledge and understanding of AMR, to conserve and steward the effectiveness of existing treatments and to stimulate the development of new antibiotics, diagnostics and novel therapies. Will she explain how the findings by Public Health England on increasing antibiotic usage and increasing proliferation of resistant bacteria square with the first of those strategic aims? According to the five-year plan, the aims were informed by the 2011 European Union AMR strategic report, so we should recognise that we are already behind the curve.

The Government seem no closer on the third aim, the development of new antibiotics, although I recognise that that is a difficult problem to solve. The Science and Technology Committee report states that

“the Government needs to work with researchers, investors, small and medium sized enterprises, large pharmaceutical companies and other Governments to urgently identify appropriate economic models that might encourage the development of new antimicrobials.”

Since the Prime Minister’s announcement of the commission to review the situation we have heard nothing further from the Government. I hope that the Minister will be able to give assurances that the review, which will clearly take some years, will not be simply a substitute for any action that could be taken immediately and that, in giving those assurances, she will explain what action the Government are taking in the meantime and what discussions they—or officials, critically—have had with the stakeholder groups highlighted by the Committee’s report.

It is clear that this is an international issue that requires work across Governments. We warmly welcome the G8’s commitment to tackling it, but it is clear that more needs to be done. It cannot be solved simply by eight countries acting by themselves; wider engagement is needed. Will the Minister therefore update Members present on discussions with counterparts throughout the world and the actions that are being taken internationally?

Finally, I want to question the Minister on the pressures on primary care. One often-cited solution to over-prescription of antibiotics is to administer them only if a patient’s condition worsens. While that is a sensible approach that, where clinically appropriate, reserves antibiotics for the most serious cases, in reality the pressure on GPs means that that is not always a credible or deliverable solution.

At present 13 million people wait more than one week to see their GP. During that time, symptoms could worsen and antibiotics could be the only treatment available to people when they are seen. If they had been seen earlier, however, alternative clinical options might have been available to them. Relieving the pressure on primary care must form part of the toolkit that should be employed to tackle AMR, yet it seems that, at the moment, the Government have no response.

The tackling of antibiotic resistance is incredibly important. The CMO has said that the threat posed by AMR is on a par with international terrorism and the Government’s wishes and rhetoric must be backed up with action. That is the settled will of the Chamber and I am sure that it is also that of all 648 sitting Members of Parliament. Where the Government do the right thing, they will have the full support of the Opposition without question. This is too important to be subjected to the banalities of party politics, so let us get on with it.