Charter for Budget Responsibility

Debate between Jane Ellison and Philippa Whitford

Wednesday 20th July 2016 Commons Chamber

[Dr Philippa Whitford]

We often talk about bequeathing the public debt to future generations, but is not what is actually happening private debt—huge mortgages, study loans and so on?

[Jane Ellison]

The hon. Lady makes her point. Fundamentally, if we look at the debt the nation is carrying forward, the point remains that it is totally unrealistic of the Opposition to imagine that we can borrow massive amounts of money after they have spent the past six years voting down any spending cuts that were proposed by the Government. They just do not have the credibility to make that point.

We have seen, as a result of the referendum, how important it is that we have an approach that ensures that we are ready for any surprises that come our way. The Prime Minister told the House earlier that we have not abandoned the ambition to move to a surplus. As we have made clear, we will be setting out further details in the autumn statement.

Making savings, living within our means, and spending money efficiently are just one side of the task ahead. We cannot afford to take our foot off the pedal when it comes to creating the right conditions for growth, and there are many ways in which we can do that. In all fairness, speeches in this debate addressed that. For a start, we know that if we want to help our economy grow, we need to invest wisely in the right infrastructure. There has been much discussion about infrastructure spending, but some of that discussion has suggested that it is rather a binary choice between living within our means on the one hand and investing in infrastructure on the other, but, as the Chief Secretary said at the beginning of the debate, that is simply not true. We are putting more than £100 billion into infrastructure over the course of this Parliament alone, and that will go to funding some essential improvements and new developments right across our country. We will keep working to make sure that this country keeps improving the skills in our workforce so that our businesses have what they need to stay on top.

It is important that we remain resolutely outward-facing. Now is not the time to pull up the drawbridge. Now is more than ever the time to open the door and to hear the message of young people that they want us to be an outward-facing nation. We want to seek all those international opportunities. We heard not a single word in the debate about today’s employment figures, which reveal that youth unemployment is at its lowest since 2005. That is surely something that we should celebrate, for the sake of our young people.

It is vital that the UK remains one of the best places in the world to do business. We are sending out that message loud and clear. That involves making sure that our tax system remains fiercely competitive. It also means that we have to continue to take difficult decisions elsewhere to balance the books, because we have made major cuts in corporation tax to create that extremely competitive environment to attract business. Only this week we saw a great example of inward investment in our country.

Without doubt there are a range of challenges ahead, but there are also a range of ways in which we can continue to bolster our economy as we open a new chapter for the UK outside the EU. We are determined to do everything we need to do as a Government to restore confidence, stabilise the economy and navigate our way through the times ahead. As we start our negotiations to leave the EU, we will tackle those new challenges head-on and we will take on board any new risks that start to emerge.

It is vital that we send out a message of confidence, and not just from the Government. It is important that we as a nation and we as a House send out a message of confidence, and some of the speeches today, I am afraid, bore no relation to the reality of life beyond this Chamber. It is important that we send out a unified signal that Britain is open for business, that we remain outward-facing and open to inward investment, and that we have confidence in ourselves as a country and in all the things that we can achieve in the years ahead. The hard-won reputation that we have as a good place to do business cannot and will not be squandered as we look for those new opportunities. For all those reasons and many more, the Government reject the motion and urge the House to do the same.

Question put.

NHS Commissioning (Pre-Exposure Prophylaxis)

Debate between Jane Ellison and Philippa Whitford

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

I thank my hon. Friend for his kind words. I take this issue extremely seriously. He is right to say that we face a challenge in relation to HIV rates, and particularly, as I said, STI rates in the high-risk MSM community. I stress again that while it will no doubt have an important part to play, PrEP is not a silver bullet for sexual infections, particularly in some of those high-risk groups. It is important to understand that. We have to continue to look at a whole range of measures. When I recently met the chief executive of the Terrence Higgins Trust, we touched on this.

As my hon. Friend says, we have a meeting coming up. I apologise for not responding to the shadow Minister’s question about meeting stakeholder groups. Of course I will meet all the key stakeholder groups. I have already had some formal and some informal discussions on this, but of course I am very open to having further such discussions. Stakeholders were involved in the process that NHS England has been involved in. NHS England has made its position clear, and there is a matter due to go before the courts on which I will not comment further. Yes, I will engage on this. Yes, of course I accept that we need to do more, and of course we all share the concerns about rising HIV infection rates, particularly among the MSM community. I too lost friends to the AIDS epidemic that my hon. Friend mentions. I take this issue extremely seriously, but we have to follow a sensible process, and that is what the Government are doing.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Anyone in this House will be glad to see the results of the PROUD study and the 85% reduction in new infections. However, there is more to understand, in that we did not see a good response in heterosexual women. While over 40,000 HIV sufferers in the UK are men who have sex with men, 60,000 are heterosexual or bisexual, predominantly of African origin, and we need to think of them in this regard.

My main complaint is on the failure to go through a process of looking at clinical evidence and cost-effectiveness and then making a decision. Why was the company not encouraged to get through this earlier and go to NICE? I do not understand why we are only going to NICE now, because that gives the answer that we need. It is relatively poor of NHS England to have made the decision on the basis of, “It’s not our job—it’s your job.” That is the most insulting bit for the community. In Scotland, our Cabinet Secretary asked it to go through the European Medicines Agency, which it applied for in February, and then the Scottish Medicines Consortium. It is on the right path now, but that is where we should have gone first.

[Jane Ellison]

It is probably worth clarifying that we asked NICE to undertake an evidence review, not a technology assessment. What drugs are licensed for are matters for drug companies to address. The Government do not initiate the process on whether a drug is licensed— the drug company must initiate it. It also worth noting that when a drug is licensed for a new purpose, as would be the case for Truvada in PrEP, the company could apply for the patent to be extended to cover this new use. Again, that is something that the drug company would do.

On the hon. Lady’s first point, I agree that we need to consider the impact on women in the circumstances she described. That is one of the arguments for carefully planning this pilot programme and taking those sorts of factors into account.

Meningitis B Vaccine

Debate between Jane Ellison and Philippa Whitford

Monday 25th April 2016 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I thank all hon. Members who have spoken in this important debate. As others did, I start by offering my condolences to the family of Faye Burdett, whose tragic death sparked such interest in the e-petition that led to this debate, and to all the other parents. Their powerful testimony on their personal family tragedies has led us and their Members of Parliament here today, and they have helped to stimulate interest in the petition, which has huge support, with more than 820,000 signatures. The petition goes right to the heart of the concern that parents and the public have about meningitis.

I have listened to the many hon. Members who have spoken this afternoon and, like everyone in the Chamber, I have been moved by the stories we have heard of how both meningitis and septicaemia have affected families and, in some cases, have tragically changed their lives forever. As has been made clear, meningococcal meningitis—the infection and inflammation of the lining of the brain—and meningococcal septicaemia, or blood poisoning, which for simplicity I will refer to as meningitis, are very serious infections that can be severely disabling and even fatal, as has been movingly and, in some cases, starkly demonstrated by hon. Members today. It is right that we should have robust arrangements in place to protect against this disease. In fact, we are the only country in the world with a vaccination programme for all the major causes of meningitis, and it is clear from the strength of feeling today that hon. Members fully support the meningitis and other world-class vaccination programmes that we have in place to protect individuals, particularly children, and the community as a whole by vaccinating against preventable diseases.

For 35 years successive Governments have based decisions on vaccination programmes on independent expert advice from the Joint Committee on Vaccination and Immunisation, and it will help to answer one or two points that have been raised if I clarify the JCVI’s legal basis. Since 1 April 2009, the Health Protection (Vaccination) Regulations 2009 have placed a duty on the Secretary of State for Health in England

“to ensure, so far as is reasonably practicable, that the recommendation of the JCVI is implemented”

where certain conditions are met, including that the recommendation is

“in response to a question referred to the JCVI by the Secretary of State”

and that it is

“based on an assessment which demonstrates cost-effectiveness”.

That is the basis on which the JCVI was constructed and under which it operates.

At the recommendation of the JCVI, as the House knows, we introduced in September 2015 a men B programme, using the vaccine Bexsero, for babies born on or after 1 July 2015. The babies receive a dose of vaccine at two months, with a further dose at four months and a booster at 12 months. To ensure that we have protected as many infants born in 2015 as possible from men B before the usual winter peak in cases, we also offered the vaccine to babies born in May and June 2015 as part of a one-off catch-up programme, which was possible because the vaccinations could take place when the babies were due to attend their routine immunisation appointments at three and four months.

By May 2016, all infants under one will have become eligible for the men B vaccine, and by May 2017 all children under two will have become eligible for vaccination, which clarifies the points made by my hon. Friends the Members for Erewash (Maggie Throup) and, in particular, for The Cotswolds (Geoffrey Clifton-Brown). Obviously, much of today’s debate has focused on extending the men B vaccination programme, and hon. Members and those who signed the e-petition want us to go further, which I absolutely understand. The term “meningitis” strikes fear into the heart of any parent. Public Health England surveys parental attitudes, and its surveys regularly show that meningitis is the disease that parents fear the most. When we hear sad stories and see utterly heart-breaking pictures of children such as Faye, of course it adds to parents’ fear and worry. They want what is best for their children, which includes protecting them from meningitis if there is a means available to do so.

The Government feel the same, which is why we became the first country in the world to introduce a programme using Bexsero. However, although meningitis is a much-feared disease, it is now much rarer, thanks in large part to the success of this country’s immunisation programmes. Cases are currently at their lowest numbers in more than two decades. To give the House an example drawn on by the hon. Member for Central Ayrshire (Dr Whitford), who spoke for the Scottish National party, cases of meningitis C have dropped from a peak of around 900 in 1998-99 to about 30 cases in 2014-15. Very few children will get meningitis, and thankfully, deaths are uncommon, although no less tragic.

The hon. Member for Central Ayrshire also mentioned teenagers. As I have enough time, I will draw the House’s attention to the men ACWY programme that we have introduced. Men W is the strain of meningitis that has increased; cases have been increasing since 2009. There were about 50 cases in 2012-13, about 100 in 2013-14 and around 180 in 2014-15. We rapidly introduced a vaccination programme this year as part of an emergency response to control the national outbreak of group W meningococcal disease. Provisional data show men ACWY vaccine uptake at around 34% in the urgent catch-up cohort aged 17 to 18 in 2014-15. I say that to enlist the help of hon. Members when we try to increase awareness of the men W campaign again this year. We need any help that can be given in publicising it. As I remarked with one colleague before the debate, it is considerably harder to get teenagers to the GP than small infants. It is an important campaign involving a very dangerous strain of meningitis that we must continue to bear down on.

However, the petition is about men B. It calls for the men B programme to be extended to children up to 11 years, although several hon. Members have suggested that up to five years may be a compromise. I fully understand why parents and the public want the extension, but as we have begun to explore in this debate, it is not a simple matter; I hope that hon. Members agree. Some of the reasons for that have been teased out, and I will say a little more about them.

Any Government must make the best use of the resources that they have to ensure that they deliver the maximum health benefit to the population. The greatest burden of meningitis B falls on the under-ones, who have therefore been our focus, on expert advice. As we have heard, such judgments are based on NICE’s rules on cost-effectiveness, which have helped successive generations of Ministers to make difficult decisions that are none the less fair and justifiable and reflect, as the Chair of the Health Committee said, the many challenges across our healthcare system.

I have spoken in detail to Professor Andy Pollard, the chair of the JCVI, to understand what process the committee went through when considering the men B vaccination and to be assured that the committee’s recommendation is robust. I have been reassured that the programme we have is the right one, targeting the group of children at highest risk of disease and death. Professor Pollard confirmed that a catch-up programme for one to four-year-olds would not be cost-effective at a realistic vaccine price. Also, the disease is so rare in those aged five to 11 that a programme for that age group would not be cost-effective, and the JCVI could not recommend it.

[Dr Whitford]

Is it not the case that the JCVI did a cost-effectiveness analysis using a 1.5% discount, which is the same as in public health, and at that level a catch-up programme for one to five-year-olds would be cost-effective?

[Jane Ellison]

I am coming to that point, but I thank the hon. Lady for her intervention.

As it stands, on the evidence and advice that I have received, I cannot support extending the men B vaccination programme to older children, but I emphasise that the JCVI keeps under review the evidence relating to all vaccination programmes, and I know that it will consider all the points made in this important debate. If the committee’s advice changes, I will consider it as a priority. The JCVI also keeps the eligibility criteria under review. I wrote to the chair on 17 March this year, following the evidence session with parents, asking the committee to review the cost-effectiveness evidence for one to two-year-olds, which Professor Pollard mentioned in his evidence to the committees. I await formal advice on that. Again, if the JCVI’s advice changes, I will consider it as a priority.

Many of the contributions made by hon. Members in this debate have queried whether the cost-effectiveness methodology used by our experts is right for immunisation programmes. The shadow Minister drew out that point, as did others, including my hon. Friend the Member for Bath (Ben Howlett), who led the debate on behalf of the committees. As some hon. Members said, an independent expert group—the Chair of the Health Committee gave it its full title, but I will call it CEMIPP for ease—is considering the cost-effectiveness methodology for immunisation generally. It includes factors such as peace of mind, cost of long-term social care for surviving children and how prevention is taken into account, all of which have been mentioned in this debate, as well as the issue of discounting.

The CEMIPP review is considering whether current discount rates are appropriate for vaccination in general, and it will report in the summer. I will consider any recommendations on that, although obviously I cannot pre-empt decisions in this debate. As I indicated to the Chair of the Health Committee when she made her contribution, I look forward to receiving the report in the summer. I have committed to publishing the report, and I do so again. If it is of interest, I will also provide the Petitions and Health Committees with a written briefing summarising the report and the Government’s proposed next steps when we get it.

Several hon. Members have expressed concern about whether the research requested by JCVI into whether a men B vaccination programme for adolescents would be cost-effective will take place and how long it might take. I can confirm that a preliminary study of the meningococcal strains carried by teenagers is now under way and will report in February 2017. It will inform a larger study of the effect of men B vaccination in that group. As the Chair of the Health Committee said, it is about exactly how the impact of the larger group would bed down on the impact of the disease in smaller children. I commit to the House to commission the second, wider study following on from the preliminary study now under way on strains.

I recognise that Members have concerns—again, the hon. Member for Central Ayrshire mentioned this issue—about how long the research is taking. I have had extensive discussions about that, because like hon. Members, I want quick answers. However, things are sometimes difficult to weigh in the balance. Robust scientific studies on which long-lasting and important decisions can be taken take time. My scientific advisers have told me that this is a particularly complex study, and that a previous study had inconclusive findings. We want to get this one right and ensure that we have a definitive answer. I am hopeful that this study could start in December 2017. The House has my complete assurance that we will always go with as much speed as we can while maintaining important robustness, so that we reach answers on which evidence-based policies can be made.

Much has been made about the importance of raising awareness and ensuring quick treatment. As many have said, no matter what the nature of the vaccination programme, there will still be cases, and we need to bear that in mind. Many Members have spoken of the reassurance that vaccinations offer and how they set minds at rest; it came out particularly in some of the evidence sessions. Although it is important that it reassures parents, I take this opportunity to underline and stress that vaccination is not a silver bullet. Even with a vaccination programme up to the age of 11, there would still be men B cases in under-11s, as we think that the vaccine covers only about three quarters of all men B strains and no vaccine is 100% effective.

A number of people have made the point, including the hon. Member for Central Ayrshire in an earlier intervention, about understanding the impact of the programme. No other country has introduced a free vaccination programme.

There is as yet no evidence regarding the real-world effectiveness of Bexsero in preventing meningococcal disease in a population—that is different from the safety issue—because, as has been said, incidence is too low for clinical trials to provide a reliable measure of effectiveness.

In response to points made by my hon. Friend the Member for The Cotswolds, I will say that we should have some indication later in 2016 of how effective the vaccine has been. However, establishing an accurate measure of how effective the vaccine is, how long the protection lasts and what proportion of strains it will prevent will take many years of detailed observation by Public Health England, and that clearly will feed into the ongoing review and the important decision-making process that we have. It is worth making that point.

Victims of Contaminated Blood: Support

Debate between Jane Ellison and Philippa Whitford

Wednesday 16th December 2015 Commons Chamber

[Jane Ellison]

That point is well made and very much on my mind. When I can say more about the shape of our proposed reformed scheme, I hope my hon. Friend will see that we have tried to respond to her concerns and those of many other right. hon. and hon. Members.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

The Penrose inquiry was held in Scotland—there has not been a UK inquiry—and, in response, the Prime Minister made his statement about the £25 million transitional payment. These people are awaiting a final settlement and compensation for what the NHS did to them, but their suffering goes on. We were told that the transitional payment would be made this financial year to help people get to that settlement. The consultation is on the final arrangement, but we need some action now and people need access to the new hep C drugs. The Scottish Government have written about support for fuel payments, but we need the transitional money now. It should not be kicked into the long grass.

[Jane Ellison]

This certainly has not been kicked into the long grass. As I have told the House, it is my intention to consult in January. I have said before, but it is worth repeating, that although we are working to establish a fair resolution, liability has not been established in the majority of cases, so it is not appropriate to talk about compensation payments, particularly on the scale that some campaigners and colleagues envisage. I have been open about that for many months. The hon. Lady is right to make the point about treatments, and all those things will be considered. I can confirm to the House that, although the £25 million was allocated to be spent in this financial year, it will be carried forward. The money that the Prime Minister announced in March was to support the transition of the scheme, which we envisaged beginning next spring, following the consultation. The money will support that, and it will be carried forward.

Sugary Drinks Tax

Debate between Jane Ellison and Philippa Whitford

Monday 30th November 2015 Westminster Hall

[Jane Ellison]

I am going to come on to teaspoons, and I do not want to run out of time before I do so. I will make a bit more progress and then see how we are getting on for interventions.

The Government cannot tackle obesity alone. I welcome the fact that we have consensus across the House on that, and the Committee draws that point out in its report. Businesses, health professionals, schools, local authorities, families and individuals have a role to play, as my hon. Friend the Member for St Austell and Newquay (Steve Double) brought out.

I want to talk about some of the industry action that has been taken. There has been progress in recent years on reducing sugar consumption. The focus under the voluntary partnership arrangements, which have been discussed, has been on overall calorie reduction, of which sugar can form a part. Billions of calories and tonnes of sugar have been removed from products and portion sizes have been reduced in some areas. Some major confectionery manufacturers have committed to a cap on single-serving confectionery at 250 calories, which is an important step.

We have to be realistic about consumer relations, which are important. Before I was an MP, I worked for the John Lewis Partnership—John Lewis and Waitrose—and I know only too well the important role that retail relationships play in an average family’s life. We need to involve those partners. Some retailers have played a part, for example by removing sweets from checkouts. Interestingly, they did so after asking their customers in surveys what support they wanted, as family shoppers, from industry to help them to make healthier choices. Much of the action that retailers have taken was in response to that.

I was very interested in the point that my hon. Friend the Member for Salisbury (John Glen) made in an intervention about consumer power. There is much greater consumer power to be unleashed, but the challenge to the industry to make further substantial progress remains. Like the Chair of the Health Committee, I have had some encouraging conversations in that regard, but we need to make more progress.

Providing clear information to consumers to help them make healthier choices is important, as a number of hon. Members have set out. The voluntary front-of-pack nutrition labelling scheme, introduced in 2013, plays a vital part in our work to encourage healthier eating and to reduce levels of obesity and other conditions. The scheme enables consumers to make healthier and more balanced choices by helping them better to understand the nutrient content of foods and drinks.

I turn to the issue of teaspoons of sugar, which has come up a lot in the debate. It is more complicated than something so simple should be; “teaspoons” sounds straightforward, but labelling is an EU competence, so member states cannot mandate additional forms of expression, such as spoonfuls of sugar, for pre-packed food. Under EU legislation, it would be possible for companies to represent sugar content in the form of spoons of sugar or sugar cubes on a voluntary basis, as long that met a number of EU criteria—I will outline what some of them are. It would sit alongside front-of-pack nutrition information, which I remind the House is voluntary, not mandated, in order to meet the same criteria.

[Dr Philippa Whitford]

For the public nowadays, “teaspoons of sugar” is more helpful than “sugar cubes”, because very few people use sugar cubes.

[Jane Ellison]

I am aware of that; the point has been made to me a number of times.

Let me mention a few of the criteria that would apply if we were to move in that direction. There would be a requirement to consult, and we would have to ensure that any measure was supported by scientific evidence and did not constitute a barrier to trade. Any such form of labelling would need to be agreed with the Commission before it was implemented, to avoid future infraction proceedings.

I have heard the strength of feeling in the House and I understand the point being made, but references to sugar cubes are quite powerful; last year’s Sugar Swaps campaign proved that they can be made meaningful. However, I will ask my officials to look carefully at the issue, because I have heard a great deal of interest in it being expressed today, and I know that the Health Committee took evidence on it. I wanted to underline the point that it is not as straightforward as it might seem, but we will look closely at it again in the light of the interest in it.

[Dr Whitford]

Did the same apply to cigarettes? Were we not allowed independently to add the warnings and so on that we put on cigarettes in this country? Did that have to be EU-wide?

[Jane Ellison]

As we approach the transposition of the new EU tobacco directive, the hon. Lady will see that the measures being taken are EU-wide, but those are two slightly different things. I am happy to come back to her in more detail after the debate, but generally speaking, packaging and labelling are EU competences.

I was delighted to hear so many hon. Members say that front-of-pack labelling was important. The scheme is popular with consumers. It provides information on calories and levels of specific nutrients in an easy-to-read, intuitive format. Businesses that have adopted the scheme account for two thirds of the market for pre-packed foods and drinks. Within the Change4Life programme, front-of-pack colour-coded nutrition labelling will continue to be included as a key message whenever there is a campaign focused on healthy eating. We use that in all the Change4Life materials, across a wide range of formats.

I want to reassure the hon. Member for Worsley and Eccles South (Barbara Keeley), who spoke from the Opposition Front Bench, that there will indeed be a physical activity strand in our childhood obesity strategy. I agree with the balance that the Health Committee struck on tackling childhood obesity, which is an important strand of the work. The great news about physical activity, as the Committee’s report underlined, is that it is good for everyone, whatever their weight. There is no downside to being more physically active, so of course we will want to reflect that.

This has not been touched on much this afternoon, but there is also a significant role for the family of health professionals in giving advice and supporting families to make changes to their lives. That relates particularly to families in more deprived communities. Only this morning I was talking about the role of health visitors, for example, in family education and family support. Again, a strand of our strategy will develop that.

Secondary Breast Cancer

Debate between Jane Ellison and Philippa Whitford

Wednesday 21st October 2015 Westminster Hall

[Jane Ellison]

I am sure we would all agree with that important point.

I will finish by discussing the new guideline that the clinical reference group is developing. The guideline will state that all patients with primary breast cancer should have a consultation with a clinician at the end of treatment that will include advice on spotting signs and symptoms that might indicate secondary breast cancer. That information will be delivered together with an assessment of the patient’s physical, psychological and social needs—I am interested in the distress thermometer that the hon. Member for Central Ayrshire mentioned, as well as in the contribution of the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron). The overall recovery package is being developed in partnership with Macmillan Cancer Support. The evidence is that that work is very effective where it has been done well. The advice that has been given will be recorded in the records of every breast cancer patient so that we know it has happened and so that we can track it.

NHS England hopes to publish the new guidance as a cancer resource on its website in the next few weeks. We will promote that guidance through the usual channels, but we would appreciate it if hon. Members with a particular interest, and particularly my hon. Friend the Member for North Warwickshire—I congratulate him on his appointment as co-chair of the all-party group—could draw this important document to people’s attention.

The clinical reference group will also consider how the care and support of patients diagnosed with secondary breast cancer can be improved, including through the provision of clinical nurse specialists. Of course, we agree that clinical nurse specialists play an important role. The number of patients reporting that they have been given the name of a CNS rose from 84% in 2010 to 89% in 2014, including 93% of breast cancer patients. We are doing a lot better, but hon. Members are right to highlight that, in the case of secondary breast cancer, we have some distance to go.

Members have said that we need to step up on palliative care, particularly in the light of last month’s debate—the hon. Member for Central Ayrshire made an important speech in that debate. We are committed to ensuring that everyone has access to high-quality, personalised palliative care. Breast Cancer Care’s new report, “Too little, too late”, is an important contribution to the debate about what we need to do. The Government have introduced five new priorities for end-of-life care—those are five important new principles—and my ministerial colleagues will be taking that forward. Nevertheless, I welcome Parliament’s new focus on palliative care and quality end-of-life care, which is important.

In the few seconds that I have remaining, I want to give people confidence that a lot of research is going on in this area. There is more research into cancer than any other disease in terms of National Institute for Health Research funding. In particular, the NIHR’s clinical research network is currently recruiting patients for nearly 100 trials and studies in breast cancer. One is a global trial that aims better to control secondary breast cancer using a drug called a dual mTOR inhibitor. I am delighted to say that the network recruited the first patient in the world to this trial, which I hope is an indication of the importance of our research infrastructure.

[Dr Whitford]

Will the Minister give way?

[Jane Ellison]

I am afraid that I do not have time to give way. We can speak after the debate; I apologise.

A lot of other things are going on in that area, but I will leave just a few seconds to my hon. Friend the Member for North Warwickshire. However, I reassure Members that this subject is of huge importance to the Government.