Antibiotics (Primary Care)

Jim Shannon Excerpts

Monday 23rd November 2015 Commons Chamber

[Maggie Throup (Erewash) (Con)]

First, I would like to declare an interest. Over 20 years ago, I was responsible for trying to launch a C-reactive protein point-of-care test, along with other point-of-care tests. The timing and circumstances were not right then, but things have moved on, and I believe the time is now right to get C-reactive protein point-of-care testing established in the primary care setting.

Last Monday was world antimicrobial day and that, along with the extensive media coverage over recent days about antimicrobial resistance and the vast difference between summer and winter antibiotic prescribing, makes this is a very timely debate. Antibiotics have been widely used to treat infections for more than 60 years, and without doubt the use of antibiotics has saved many millions of lives. I doubt if there is any right hon. or hon. Member who has never taken an antibiotic at some time in their life, but such extensive use of antibiotics has now become a real issue and a ticking timebomb.

Although new infectious diseases have been discovered nearly every year during the past 30 years, very few new antibiotics have been developed in that time, meaning that existing antibiotics are used to treat more and more infections. The consequence has been an increase in the prevalence of resistance to antibiotics, which in turn puts our ability to treat routine diseases in serious jeopardy. At present, treatment-resistant bacteria are responsible for approximately 25,000 deaths across Europe each year, which is a similar number to those dying in road accidents. The national risk register of civil emergencies has estimated that a widespread outbreak of a bacterial blood infection could affect 200,000 people in the UK. If it could not be treated effectively with our existing drugs, approximately 40% of those affected might die as a result, which is 80,000 people. There is an urgent need for action to slow the spread of antimicrobial resistance.

For a number of years, there has been a clear consensus among clinicians, academics and policy makers that antimicrobial resistance represents a major current and future danger to the foundations of modern medicine. In recognition of that danger, tackling the threat of antimicrobial resistance has been identified as a key priority by the Government, Public Health England and the chief medical officer. Just two years ago, the chief medical officer described the threat of antimicrobial resistance as

“just as important and deadly as climate change and international terrorism.”

I wish to focus on antibiotics in primary care and what measures can be taken to have a real impact on the way in which they are prescribed, which is currently almost like handing out a bag of sweets at the fair. In fact, 97% of patients who ask for antibiotics are prescribed them, whether or not they should have them. Owing to the popularity of primary care in the UK, that setting represents the part of the healthcare system where antibiotics are most likely to be prescribed, with 74% of them prescribed in that setting. International comparisons show that antibiotic resistance rates are strongly related to antibiotic use in primary care.

Despite guidance encouraging a reduction in antibiotic prescribing rates, nine out of 10 GPs say that they feel pressured into prescribing antibiotics. In the UK, we do like taking antibiotics. In 2013, data showed that 41% of residents had taken antibiotics in the previous 12 months, compared with a European average of 35%. Nationally, in 2013-14—the most recent year for which I have managed to get hold of the data—a staggering 41.6 million antibiotic prescriptions were issued, at a cost of £192 million to the NHS.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing the Adjournment debate. She has outlined the issues and the epidemic potential among those who do not respond to antibiotics. Does she agree that we need something focused not just on England and Wales, but on the whole of the United Kingdom of Great Britain and Northern Ireland because this strategy has to help us all? In her submission to the House, will she say—perhaps the Minister could respond along the same lines—whether we should have a UK-wide strategy to address the issue for the constituents of all Members of the House and further afield?

[Maggie Throup]

I completely agree with the hon. Gentleman. It is not just a UK-wide issue; it affects the whole world. That is one of my concerns. We need to play our part to set the trend for the whole world, because this is a global issue.

As I said, antibiotic prescriptions in 2013-14 cost the NHS £192 million. What is more worrying is that many of the 41.6 million prescriptions were unnecessary and will undoubtedly have contributed to the growing issue of antimicrobial resistance. More than half the antibiotics used in primary care are for respiratory tract infections, most of which are viral or self-limiting.

So what can be done to halt the ticking timebomb? Just last Wednesday, Public Health England called for NHS patients to become “antibiotic guardians” by thinking carefully before asking for drugs and taking more care to prevent the spread of infections by washing their hands and accepting the flu jab. I believe that we can go even further in reducing the use of antibiotics in ways that are better for the patient and that save the NHS money.