Oral Answers to Questions

Jo Churchill Excerpts

Tuesday 19th July 2022 Commons Chamber

[Steve Barclay]

I know this is an issue of concern that the hon. Lady wrote to my predecessor about, and indeed she raised its impact on her constituency in the House last month. There are specific programmes such as the targeted enhanced recruitment scheme that was launched in 2016, and the one-off financial incentives to attract GPs to the more deprived areas. We are also looking at how we can have the right skills mix to boost not just the number of GPs but wider access to appointments.

[Jo Churchill (Bury St Edmunds) (Con)]

I welcome my right hon. Friend to his place. I offer a solution. Will he commit himself to sorting out the transfer of electronic prescriptions between hospital consultants and GPs, which would stop people trying to get appointments for prescriptions written in hospital. That would simplify things enormously, and my GPs would really welcome it. We could also do rural dispensing doctors while we are at it.

[Steve Barclay]

I always welcome solutions from colleagues on both sides of the House. From memory, Tim Ferris, who leads on tech within the NHS, is looking at a tech solution—I think it is in beta testing, although I would have to check. Appointments made shortly after a person has been discharged from hospital are often quite complex cases and create additional pressure on GPs.

Another issue I am keen to explore is GP appointments that can be done through either better use of technology or the wider skills mix so that we can better focus GPs’ time on more complex cases where their expertise delivers the best patient outcomes.

Covid-19: Shielding

Jo Churchill Excerpts

Wednesday 15th September 2021 Written Statements

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

Shielding was introduced at the start of the pandemic as one of the few interventions available to support those who, at the time, were considered clinically extremely vulnerable.

We know shielding advice is extremely restrictive and has a significant impact on people’s lives and their mental and physical wellbeing. It was right to take this step to protect the most vulnerable during the initial waves of the virus, and we put in place support for those who were advised to shield to help them to do so.

We now know much more about the virus and what makes someone more or less vulnerable to covid-19. We are also in a different situation than we were at the beginning of the pandemic. The vaccine continues to be successfully rolled out, with millions of people having received both doses and a booster programme about to commence. We also have proven, effective treatments, such as dexamethasone and tocilizumab, to support improved outcomes in clinical care pathways.

We have not advised people to shield since 1 April. Since 19 July, the guidance for clinically extremely vulnerable people has been to follow the same advice as everyone else, with the suggestion of additional precautions people may wish to take. Those patients who are at risk from infectious diseases more generally and who can also remain less protected after other vaccinations may wish to discuss this with their specialist as part of their routine care.

Due to the success of the vaccine rollout, improvements in treatment and clinical care, and growing understanding of the virus, the Government have accepted expert clinical advice and decided to end the shielding programme and the requirement for centralised guidance for people who were considered clinically extremely vulnerable.

This moves us towards the situation pre-covid where individuals managed their own conditions with their health professionals. We believe this is a proportionate decision based on the success of the vaccine programme and the protection it offers, the availability of effective treatments and the highly restrictive impact of shielding on people’s mental health and wellbeing.

[HCWS291]

Health and Care Bill (Fourth sitting)

Jo Churchill Excerpts

Committee stage
Thursday 9th September 2021 Public Bill Committees

[The Chair]

Right. We have two Ministers now. Jo, did you want to ask something?

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

No, my question was covered earlier. I had assumed that I would be called as a Back Bencher, if you see what I mean, as I am not the lead Minister on this Committee.

[The Chair]

I apologise for that, but I understood that we had decided to share the time between Back Benchers and Front Benchers, and I counted you among the Front Benchers. There we go. Never mind.

[Jo Churchill]

Q I will ask a supplementary. We have spoken about discharge. I have a particular interest in how we develop the system by the use of ICBs and ICPs in order to highlight prevention. Very often, admission is the result of issues before, and as Stephen highlighted and Gerry alluded to, carers and families all take the weight of the stress when somebody is admitted, and when somebody is discharged and needs reablement. What does the Bill do, or what would you like to see in it, to help prevent people falling ill?

Stephen Chandler: The Bill reaffirms and formalises the requirement to plan very carefully for the population at a place level first, and then at a system level. In doing so, it sets up an integrated care partnership with a clear set of objectives, based on the population. Of course, it emphasises the importance of prevention as a way of helping people remain healthy and well for longer.

In Oxfordshire, we have set up our shadow partnership, and one of the areas we are looking at is our out-of-hospital support—particularly how we can avoid the need for hospital admissions. Again—this goes back to a point I made earlier—in doing so, we are looking at how we as a system can contribute individually, and therefore collectively, to reducing crisis and therefore the need for hospital admission. It has changed the tone of the discussion from, “Isn’t that an NHS responsibility, whether primary care or secondary care?” to, “How can we do better for our population?”.

You might say, “Well, hold on. That sounds like a very subtle change.” Let me be clear: some of these subtle changes really do make an impact. Coming back to an earlier question about resources, this also enables us to have the conversation around the prioritisation and impact of those resources. Instead of saying, “Here is the county council’s budget plan and here is the NHS’s”, we can ask how we make best use of that collective resource. The Bill helps by formalising that and providing some additional structures and focus on that.

The Bill is helpful, but it will be interesting to see how it works where, perhaps, systems have not had positive relationships or have had a more adversarial approach. I was really lucky in Somerset, because the emerging ICS there was coterminous with the local authority. It was a single provider. It was perfect in a way. I am in an ICS now where there are three different population groups. We know some ICSs have significantly more.

The opportunity is there to be grasped. This provides a fantastic focus if it can be ensured. In fairness to colleagues, the focus seems to be “start at place and work upwards”, rather than “start at system and work downwards”, in order to make really good differences to people, particularly around hospital admission avoidance. It also gives me, from a local authority point of view, greater leverage to challenge my NHS colleagues around their investment in secondary care and community care resources, because that area has, unfortunately, seen significant reductions over the years.

[Jo Churchill]

Q So you might see a positive outflow, in terms of more investment in community, in order to keep people well?

Stephen Chandler: Absolutely.

[Jo Churchill]

Q Thank you. Gerry?

Gerry Nosowska: Prevention is always undermined by the resources moving into urgent and acute needs. In practice, social workers are not able to do therapeutic, restorative support work that they would be able to if they had the time to spend with people who need that. There is a fundamental resource issue that the Bill does not address directly, but it may help with the potential for pooling resources. Again, people in the community do not care whether it is a health or social care resource. If there is a need emerging that can be responded to, and preventive work can be done, it should happen without health and social care arguing about exactly whose purse it comes out of.

There are some really successful examples of reablement and preventing avoidable hospital admissions. We know it is possible. Scarcity does breed competition rather than collaboration, so that is something to think about. As for what the Bill might also do, the partnership strategy ought to have a very strong preventive element to it, and that needs to be dug down into locally—into particular communities, neighbourhoods and streets. That is where you really need lived experiences. I have a question about the regard that the integrated care board would have to that, and the potential for a wonderful, collaborative partnership strategy around prevention to be disregarded because of an acute need. I was listening to Robert Francis, and I think his suggestion that there be a written explanation to a local community if that happens is very good.

[Edward Argar]

Q Just one question to both of you, if I may. First, thank you for all that you and your members have done and continue to do. I say that as a former council cabinet member for adult social care and health and public health. I know the shadow Minister will share that sentiment. When I was doing that job some years ago and I was not quite so grey, the director of adult social services with whom I worked was a lady called Marian Harrington, who had been working in adult social care for a long time. A key point that she always emphasised to me was the importance of a close working relationship between the NHS locally, social care and the local council, particularly on discharge, but also on the ongoing care of people with multiple needs who were receiving social care. She would always say to me that although the framework was important, equally important were the culture, the behaviours, and trusting relationships between organisations in the framework.

I will turn to Stephen first and then to Gerry. We have sought to be permissive rather than prescriptive in this Bill. Have we struck broadly the right balance, or are there areas where it might need to be tweaked, either in legislation or in guidance?

Stephen Chandler: Your director colleague was absolutely right. I think that you have got the balance right in relation to permissiveness. I worry that the guidance does not prescribe directly how we should develop that culture, but having worked as long as I have, I realise that you cannot prescribe how relationships are formed and how cultures work. You have to create the conditions for success. Some of those conditions are in the Bill. I have talked about some of them in relation to the pooling, the boards and the assurance methodology. What has to be absolutely clear—and I am hearing it clearly, so it is not that I have not heard it—is the importance of seeing this as a vehicle for meaningful change to people’s lives, not a restructuring of health and social care. Rather, this is a vehicle for improving the lives of people in communities and systems, and for allowing health and social care professionals to maximise their individual abilities for that collective good. In a way, there is a duty on me as a leader in the system to create that culture and environment.

You have not gone into the area of assurance, but for me it is really important that when assurance looks at a system, it looks at the leadership and how that leadership translates the freedom, the permissiveness, but also the accountability, clearly. The feedback I am hearing from our members is, “We favour the permissive approach that is taken in this.” We would not say that the tolerance should be changed one way or the other.

Health and Care Bill (First sitting)

Jo Churchill Excerpts

Committee stage
Tuesday 7th September 2021 Public Bill Committees

[The Chair]

Some of our witnesses will be giving evidence today by video link, while others will appear in person. It is helpful, particularly when witnesses are giving evidence by video link, if Members could direct their questions to specific witnesses. Before calling the first panel of witnesses, I remind all Members that questions should be limited to matters within the scope of the Bill and that we must stick to the timings in the programme motion that the Committee has agreed. We have until 10.30 for our first panel. Do Members wish to declare any relevant interests in connection with the Bill?

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

I have no relevant interest to declare, but we are unable to see a screen. Would it be possible to erect a screen so that we can see those giving evidence?

[The Chair]

Yes, we can do that. As there are no witnesses giving evidence in person, it would be okay for Members to sit at the witness table, if that would be better.

[Jo Churchill]

That would be great.

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

I want to declare an interest as a medical practitioner, although not commonly practising, and as a member of the British Medical Association.

Health and Care Bill (Second sitting)

Jo Churchill Excerpts

Committee stage
Tuesday 7th September 2021 Public Bill Committees

[Alex Norris]

Q Finally, I remember from my time in local government that we would talk about the desire in social care to share data with the health service. We talked about, obviously, regulatory barriers that stopped us and we would welcome provisions that removed that, but a very practical obstacle on our list of things in the way was that the systems did not necessarily speak to each other. Do you think that health service systems and social care systems are ready to speak to each other now, or will there need to be, across all integrated care systems, a whole new provider brought in?

Simon Madden: Obviously, interoperability is absolutely key. The information standards piece that I spoke about is part of that, but also, outside the legislative piece, work is going on to create a unified data architecture. This is not about driving or having everything from the centre, so that everybody uses the same things, but about making sure that the architecture enables that interoperability so that the systems can speak to each other. There is certainly a degree of levelling up to do in terms of digital maturity, which is another area in which NHSX is involved, supporting the Department and NHS England. But yes, interoperability is key. We are not there yet; we have some way to go to make sure that everything will flow as it should and the systems speak to each other.

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

Q Mr Madden, I would like to know specifically how the strategy will help us to deliver integrated care within the confines of the Bill, so that we can give better patient outcomes, because ultimately that is what I have assumed the Bill is striving for. You did allude to how that interoperability gives us greater vision into the system. I wonder whether you could help us by bringing that to life. Thank you.

Simon Madden: The best example is something that I have already cited to a certain degree, which is the shared care record. To some degree, that would happen irrespective of whether ICSs and the Bill were in place, because health and social care need to come together; that is something that needs to happen in any event. But what the Bill does is create the proper framework of integration and collaboration. There are other powers in the Bill, for instance the duty to co-operate and collaborate, that I think are going to be absolutely crucial. From a public perspective, they see the NHS and see one organisation, whereas we all know that it is a confederation of organisations, each sometimes with different aims, pulling together. The ICS structure set out in the Bill, plus the data provisions that support that broader approach, will help provide that free flow of information so that clinicians and care professionals have access to the information they need to be able to treat patients in the most effective way.

[The Chair]

Anyone else? I will assume there are no more questions. Mr Madden, I thank you very much for your evidence.

Examination of Witnesses

Saffron Cordery and Matthew Taylor gave evidence.

Medicinal Cannabis

Jo Churchill Excerpts

Monday 6th September 2021 Commons Chamber

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

First, I congratulate the hon. Member for Edinburgh West (Christine Jardine) on securing this debate. I agree with colleagues’ comments: it has been incredibly helpful to have time to talk about this issue. As I sat on the Front Bench, the debate highlighted to me, first, the needs of these children and their families, and secondly, the complexity of the whole situation. We can make statements, but there are no easy solutions. This issue involves the medical profession, licensing and trials.

Let me thank all those who have contributed to the debate. In no particular order, so as not to upset anybody—I have met many of those who have contributed on numerous occasions—I thank my hon. Friends the Members for South Leicestershire (Alberto Costa) and for Windsor (Adam Afriyie), and the hon. Members for Strangford (Jim Shannon), for Gower (Tonia Antoniazzi) and for South Antrim (Paul Girvan).

I thank my right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright), who is not in his place but with whom I have met. As is the constituency MP for Hannah Deacon and Alfie, he has contacted me and spoken to me on several occasions.

I thank the hon. Members for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and for Inverclyde (Ronnie Cowan), to whom I shall not forget to wish a happy birthday.

As my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) said, we have known each other a long time and I have carried his bags on more than one occasion—

[Sir Mike Penning]

Not no more!

[Jo Churchill]

Not no more, but I understand where his passion comes from.

I can also see in their places the hon. Member for Manchester, Withington (Jeff Smith)—we have spoken about this matter—and my hon. Friend the Member for Reigate (Crispin Blunt).

At the heart of this debate for me are Alfie; Billy; Eddie Braun, who was not mentioned; Murray; Jorja; Maya; Bailey Williams, mentioned by the hon. Member for Gower; Sophia; and others. It is about those children. I have personally met several of the families and heard at first hand how it feels not to be able to have anything more. To be honest, as a mum of four, I can say that sympathy feels a bit useless when it comes to a mother who, in some cases, can watch their child fit 100 times a day. They have explained to me the relief that applying Bedrolite under the tongue brings to their children. They have spoken about the financial challenges, but I would like to use the time available to go over some of the challenges that I am trying to wrestle with to get to a solution.

We have had an accordion debate tonight. Initially, the hon. Member for Edinburgh West said that this debate was about access to NHS prescriptions. However, many others also spoke about how much this might benefit multiple sclerosis sufferers and those with chronic pain. Indeed, Lord Field in the other place has written to me on this subject and spoken about the relief of chronic pain that I think he himself gets from using a cannabis-based product. However, there does have to be an evidence base that is more than observational.

[Tonia Antoniazzi]

There has been a lot of talk about randomised control trials this evening, and I understand the difficulty that the NHS has with this. We have had numerous meetings with NHS England and with pharmacists on this. The issue is that the RCTs are a no-goer. They are just a no-goer. I would never take my child off a drug if I knew that it could possibly kill them in order to enable the NHS to prescribe. We have to overcome that hurdle. I would like to see a push from the Minister to make that change happen. We have seen it with covid and we have seen it with the vaccine. What the NHS has done is incredible. I would really love to have the Minister onside to be able to push the NHS forward to change its mind over the RCTs.

--- Later in debate ---

[Jo Churchill]

I understand that point and I have said to those parents that I would struggle. In fact I would probably find it impossible to offer my child something else when they were already gaining relief from something. However, as we have debated here today, there are probably two issues here: the treatment of those children who are already on Bedrolite; and the need for an evidence base, particularly when we start to talk about expanding the use of cannabis medicines for those suffering from a large range of other medical issues, be it MS sufferers and so on. This is where the challenge comes. Clinicians rightly want to prescribe based on the evidence so that they do their patients no harm. Many people have said that this is the place of last resort for these parents, but we have this difficulty.

[Sir Mike Penning]

rose—

[Jo Churchill]

I will go on to explain why after my right hon. Friend’s intervention.

[Sir Mike Penning]

I have two points. The first is that it is not all Bedrolite. A lot of these parents do not have Bedrolite. There are myriad specialist ones with different THC levels, but they have been prescribed by a consultant. I know what my hon. Friend said, but these are consultants, and they do want to prescribe the drug and they have prescribed it, but they are not allowed to put it on an NHS prescription unless you are Alfie, Billy or any of the others. It just does not make sense.

[Jo Churchill]

I agree that there are other medicines, but one of the challenges is how we treat people with ongoing needs as their conditions vary, if we do not have the ability to understand how the body is responding.

I will push on a little bit. Let me provide an update on Bedrocan oils from the Netherlands. As stated previously, the commercial agreement between Transvaal Apotheek and the UK special medicines manufacturer, Target Healthcare, is progressing. The Medicines and Healthcare products Regulatory Agency and the Home Office are working with those companies to ensure that all regulatory standards for manufacturing these medicines in this country are met. We continue to work closely with the Dutch Government, Transvaal, the Home Office and the MHRA—which I have met with and which says it will look at the international evidence—to ensure continuity of supply until domestic production has been established. We have had movement; I can sense the frustration in the House tonight, but we are moving forward. I will continue to keep the House informed of progress.

On the main topic of the debate, it is undeniable that it is incredibly hard for many of the patients and their families. As many Members have said, the challenges have done nothing but worsen during the covid-19 pandemic. The Secretary of State for Health and Social Care, my right hon. Friend the Member for Bromsgrove (Sajid Javid), when he was Home Secretary, changed the law to allow unlicensed cannabis-based products for medicinal use to be prescribed by doctors on the General Medical Council’s specialist register. This removed legislative barriers to legitimate use as a medicine. However, there is still caution across specialists in their ability and willingness to prescribe. [Interruption.] Indeed. However, with respect, if the prescribing of these medicines by a clinical specialist was that seamless, we would have more of it, but we do not.

The whole thing comes back to the fact that clinicians want to rely on an evidence base, and that includes clinicians in Scotland. We recently received a letter from the Scottish Government, outlining that Dr Rose Marie Parr, former chief pharmaceutical officer, had chaired a teleconference with key paediatric neurologists from specialist centres. The clinicians had a clear and united view that, following the GMC and British Paediatric Neurology Association guidelines, they would be unwilling to prescribe CBPMs containing THC, including Bedrolite, until there is clearer, published evidence available following a clinical trial.

[Tonia Antoniazzi]

rose—

[Dr Cameron]

rose—

[Jo Churchill]

All three Members rose at the same time. I will make my next point before I take interventions.

While the evidence base remains limited, I am sure that everybody, including clinicians in this place, will agree that decisions on whether to prescribe, as with any other medicine, have to remain clinical decisions. A doctor would not appreciate me in their consulting room telling them that they did not know their job as a doctor.

[Tonia Antoniazzi]

I thank the Minister for giving way again. I would just like to point out to her that that is not the case. There are three NHS prescriptions. If the law was changed, why are there those three NHS prescriptions? Either these medicines are safe or they are not. They must be safe. I understand what she is saying about the clinicians, but let us look at the risk-benefit for the particular group of children we are talking about. We know that “First do no harm” is how our clinicians treat their patients, but they have to move forward. Hannah Deacon is a classic example. She is continuing to campaign because she sees the unfairness and injustice that Alfie has his prescription but other children do not. Please, Minister, help us to move this debate forward.

[Jo Churchill]

Hannah has said those exact words to me. That is why I say that we have to look at this in a selection of doable, achievable pieces, because it is not possible to look at it for every condition. We are talking about those children with refractory epilepsy, and trying to find solutions there is my main focus currently.

[Christine Jardine]

I am not a medical person; I am a parent. I think back to the start of covid-19 when we were told that it would take years to do the clinical trials and to do everything that was necessary to have a safe vaccine, but now we have it, and a successful roll-out, because there was the will to do it—to think out of the box. I think for many people the frustration comes from the question of why the medical profession are not being encouraged to look at an alternative way of finding the reassurance that will enable them to be looking at the observational evidence from abroad and taking it on board. They will be looking to the Government to encourage them to do that.

[Jo Churchill]

I would like to reassure the hon. Lady that we do look elsewhere, but it fundamentally comes back to the fact that observational trials on very small cohorts are not the best way to develop the policy, going forward, to treat these individuals. That is notwithstanding the fact that the observations of all the parents I have met, and others who have seen their children benefit, are the foundation for making us try to put our shoulders to the wheel in order to do better. I think there is that tension.

Looking across other countries, my hon. Friend the Member for Windsor (Adam Afriyie) said, “If they can do it, why can’t we?” What is needed to support routine prescribing is the evidence base of safety and efficacy, public funding and cost-effectiveness. This is the system that we use in the UK for all medicines and medical devices, and it is really difficult to see a case for why cannabis should be treated differently from that on a broader spectrum, particularly when we take into account the comment by my hon. Friend the Member for Reigate (Crispin Blunt) that there is a need to look at how these medicines may help others suffering from chronic pain. I have been told that multiple sclerosis and palliative care are other areas, and so on. If we are going to broaden this, then we must look to do the job properly.

[Dr Cameron]

I thank the Minister for grappling with what is a very complex matter. I totally understand what she is saying. I can understand some clinicians’ reluctance because they do not want to prescribe something when they do not know what is contraindicated in relation to other conditions and they do not want to do harm. But this must potentially be done where the children are already benefiting from some kind of expedited process to ensure that they can have the prescriptions and that parents are not having to try to fund that in so many different ways, causing that stress. There must then be some kind of expedited clinical trial that shows that clinicians more broadly can have the confidence that they are prescribing medications that will support conditions, do no harm and would not be contraindicated or cost children or adults their lives if prescribed to the wrong individuals.

[Jo Churchill]

I thank the hon. Lady because she encapsulates in a nutshell what the challenges are. This is extremely difficult without that knowledge of what the contraindications are. I was trying to suggest, perhaps not as eloquently as I could have done, that we need these different bits in order to make the policy work. As the House has heard, the current Health Secretary was the Home Secretary when he changed the law, and at our very first meeting, he told me it was one of the things he was very keen to see us move forward on.

[Several hon. Members rose—]

[Jo Churchill]

I am going to make a little progress, because at this rate we will go up to the end of the time. I will come to my right hon. Friend the Member for Hemel Hempstead.

While saying that it should remain a clinical decision for doctors—indeed, that was very much what I took from the hon. Member for South Leicestershire, because it would be inappropriate for Ministers in Whitehall or the Scottish Government to influence individual prescribing decisions—with the exception of three licensed medicines, cannabis-based products for medicinal use are not first-line medicines and are not routinely funded. Most cannabis-based medicines are unlicensed medicines, and that means they are yet to have their quality, safety or efficacy assured by regulators here or, indeed, anywhere else around the world. Nor has their cost-effectiveness been decided by the National Institute for Health and Care Excellence, which is how we administer medicines. Those are the foundations of NHS decisions about routine funding. The cost of treatments sought privately remains the responsibility of the patients, and I am not cloth-eared to how difficult that is and why we need to try to find a solution.

[Sir Mike Penning]

rose—

[Tonia Antoniazzi]

rose—

[Jo Churchill]

I will give way first to my right hon. Friend.

[Sir Mike Penning]

The Minister is being very generous, although we have plenty of time. I think we have until half-past 10, Mr Deputy Speaker, should we or you wish. I have two questions. The hon. Member for Gower (Tonia Antoniazzi) asked a specific question: how is it safe on the NHS for three prescriptions to be given to three children, paid for by the NHS, but not any others? Is it safe, or is it not? The Minister referred earlier to clinicians not having the confidence to give the prescriptions. Is she aware that one of the clinicians was reported to the General Medical Council for writing a prescription and was exonerated? That is why they are scared; they are scared for their careers. How can it be safe for three children, but not the other children whose lives can be saved?

[Jo Churchill]

I thank my right hon. Friend. I have met clinicians, as well as the families. Like just about every other area of medicine, there is divergence in how they approach it. There are those who prescribe and those who do not. I have also spoken to Alfie’s general practitioner, who was very articulate in describing the benefits that Alfie saw from taking medicinal cannabis. However, it is still fundamentally the decision of the clinician who has the child as the patient. One thing that has been said to me is that it is important, as we try to move forward and do better, to ensure that private specialists also have conversations with those who are treating the children for other issues in their NHS care, because of contraindications and so on, as was referred to earlier.

[Tonia Antoniazzi]

I thank the Minister for being so generous with her time. The right hon. Member for Hemel Hempstead (Sir Mike Penning) has made a real point about there being a culture of fear within the NHS and with clinicians, who are too scared to prescribe because they do not know what the consequences are. The Minister has a role to play here in enabling them to have the confidence to prescribe and work with the drug that we refer to as cannabis. In this House, we should not be using the word “cannabis”, because it strikes that fear into the hearts of many, many people across the UK. Most other drugs have a single active ingredient; medical cannabis has many. If the Minister does not accept that randomised control trials are not applicable, we are in a Catch-22 situation and we are forever stuck. This is not acceptable.

[Jo Churchill]

I do not believe we are stuck, but we should proceed with caution. I think that is a totally acceptable way to go on. I think it was the hon. Member for Edinburgh West who asked why it is any different from insulin or the other drugs she listed. It is different, so we must proceed with caution.

[Christine Jardine]

On that point, will the Minister give way?

[Jo Churchill]

One minute. The cost of parents accessing private treatments remains the responsibility of patients. I am aware that the cost remains high and has brought immeasurable hardship to some families. However, the Government cannot stipulate what companies charge for these products. Furthermore, these are controlled drugs that are specially manufactured or imported for the treatment of an individual patient with an unmet clinical need. In such cases, there are also international treaties with which we have to abide, which mean that companies exporting or importing controlled drugs incur fees to support the necessary governance processes.

We have done an enormous amount within the constraints of the treaties to reduce the costs, making clear what the rules are about and how much can be imported under each notification, and allowing licensed importers to have a small additional supply so that children can get hold of a supply. The supply can be drawn from when a prescription is given by a specialist doctor, reducing the amount of time that a patient might wait for their medicine and helping to ensure continuity. However, the export of finished Bedrocan oils from the Netherlands is currently restricted under Dutch law, so the latter change does not apply to those products. The licensed cannabis-based products Sativex, nabilone and Epidiolex, for which there is clear evidence of safety clinical trials and cost-effectiveness, are provided routinely on the NHS for their licensed indications. Indeed, last month, the licensed indication for Epidiolex was expanded to those with tuberous sclerosis complex. I have heard from parents who have tried some of these drugs and found them not to be successful for their children, but it is important that as we build a better reference for cannabis-derived medicines, we have a suite of products that we can draw on.

[Christine Jardine]

I thank the Minister for giving way; she is being incredibly generous with her time. I would like to say, however, that when I referred to insulin and inhalers, I was not comparing medicine with medicine; I was talking about the principle of having to pay for something that makes such a fundamental difference to people’s lives, and how families are having to pay when, as other hon. Members have said, NHS prescriptions have been issued.

[Jo Churchill]

I apologise for the confusion; I misheard.

[Jeff Smith (Manchester, Withington) (Lab)]

Will the Minister give way?

[Jo Churchill]

One second. On the expansion of Epidiolex, NICE will work with the manufacturer to assess the clinical and cost-effectiveness of the medicine in the indicated patient group before making recommendations for routine prescribing and funding on the NHS. That is the proof. Where there is the will and investment in clinical trials, cannabis-based medicines can achieve the medicinal licence that is the gateway to routine funding. They have become a useful tool for clinicians in treating diseases where other licensed treatments have failed, but the licensing process also provides for the development of the evidence and information that doctors rely on to support their treatment decisions, as was laid out by my hon. Friend the Member for Reigate (Crispin Blunt). The MHRA is well equipped to provide advice to any prospective applicants wishing to conduct clinical trials or marketing authorisations. Indeed, there have been 13 trials ongoing in the UK in the past 12 months, and six other trials of this type of medicine have been completed.

On refractory epilepsy and the children we are specifically interested in tonight—that is not to exclude any other patient group—NHS England, NHS Improvement and the National Institute for Health Research have confirmed in principle support for two randomised control trials on early onset and genetic generalised epilepsy. These will compare medicines that contain cannabis oil, CBD only and medicines that contain CBD plus THC with placebos. While, like many other projects during the pandemic, there have been delays on commercial discussions, these are nearing completion. Once supply contracts have been finalised, the study team will be able to initiate the formal trial set-up process and confirm a date for patient recruitment. This is a pioneering area of research, and we are keen to support patients by progressing these trials as soon as possible. I feel keenly the frustration that they have taken so long, and I hope to be in a position to make a further announcement on these clinical trials in the next few weeks.

[Jeff Smith]

The Minister is being very generous in giving way, and I know she wants to find a solution to this problem. I tried to get in earlier when she referred to some parents who had used medical cannabis and found that some of it worked and some of it did not work. It sounds like an evidence base was being created there. I understand that she does not want to create a system for all our medical regulation based on observational trials, but there are many experts who say that randomised control trials will not work for cannabis and we need another way of getting the evidence. Given that we clearly have a system that is not working, is there not a case for this particular condition and this particular type of medicine being a special case? We need to find a different way of creating such an evidence base to give the clinicians comfort.

[Jo Churchill]

I will focus on the end bit. We do need to give clinicians comfort if they are going to prescribe medicines that help alleviate children’s pain. The challenge with the observational trial, as anyone who has been involved with medical trials will tell you, is that the smaller the cohort, very often the greater the problem is with the confidence intervals, and so on and so forth. There is a need to look at things by perhaps turning the telescope the other way up to see whether we can focus ourselves on approaching this in a different way to find solutions. However, the bottom line is that we need good evidence, because we have also been in this Chamber talking about drugs where the challenge to the patient has then transpired, and we later we have been here talking about the damage.

[Crispin Blunt]

Particularly in the light of what my hon. Friend has just said about turning the telescope around and thinking about this in a different way, this is not just about the United Kingdom; this is global. There is evidence all over the world that we can use, and we do have a terrible tendency of “not invented here” in some of this. There are other countries in which the authorities are finding a positive way to license this medicine. While obviously the focus is on these particular children now, behind them sit tens of thousands of people self-medicating on cannabis and making themselves criminals in the process. Behind them sit our 2,500 veterans who have untreatable trauma, who are being driven into the hands of dealers to find ways of managing that trauma. We are turning heroes into junkies because we are not advancing the science base as fast as we should.

We should be really supporting the research, which is why I am delighted to hear what my hon. Friend has just said. Let us really go for this. We can underpin the bioscience base of our country if we do so. We have just seen Dr Carhart-Harris, a leading researcher in the whole application of psychedelics, disappear from doing research in London to the United States. It is exactly the parallel argument with medicine from cannabis. We need to get behind the scientists and the researchers, and let them help our people and teach our medical profession what is available to them to help their patients.

[Jo Churchill]

That is true. However, people have to come forward with clinical trials designed in a way that is acceptable and gives us robust outcomes. We have discussed this and Psilocybin, and many other things, at some length in the past, and although tonight is not the time to carry that on I am sure we will do so again.

We take into account literature and evidence from other countries, and the guidelines published by the National Institute for Health and Care Excellence were developed in accordance with well-established processes based on internationally recognised and accepted standards. This ensures a systematic, transparent approach in identifying the best available international evidence within the scope of guidance at the time of the NICE evidence review. However, NICE found that current research is limited and of low quality, and that makes it difficult to assess just how effective these medicines are, and we need to make sure they are safe.

[Adam Afriyie]

I empathise with the Minister; this is tricky, because one does have to introduce medicines in a safe way according to a set formula and we have quite a good system.

I have two points. First, we were talking about prescribing to children untested or unvalidated medicines, yet in some treatments we are prescribing adult steroids to children. Will the Minister say something about that, as it seems slightly inconsistent? Secondly, there are patients, in particular children, who shortly will have no prescription whatsoever when the last specialist who can make these prescriptions retires. How are we going to cover that?

[Jo Churchill]

I am obviously very cognisant of the latter point, and my right hon. Friend the Member for Hemel Hempstead mentioned a court case. This adds to the need to find solutions to the problem. On adult steroids, that is a clinical decision by a doctor, and my hon. Friend would not expect me to comment on that, because we are dealing here with incredibly poorly children, and our heart goes out to them.

[Tonia Antoniazzi]

rose—

[Jo Churchill]

The hon. Lady is looking at her phone intently and jumping up again, so I will give way.

[Tonia Antoniazzi]

I thank the Minister for her generosity in giving way, and she is right that I want to make yet another observation.

One of the reasons why we all came into this House was to make change happen, and I know the Minister feels exactly the same. Maybe her hands are tied, but under the Health and Social Care Act 2012 the Secretary of State has the power to commission an investigation and research into new medicines. End our Pain has shown this to her officials several times; it has even been cited by a Queen’s counsel, whose opinion is that this is possible. This would be a great way to run an observational trial at no cost to parents; why will the Minister not take this option?

[Jo Churchill]

It is not in my gift to take that option, but I will take that comment back to the Health Secretary and have further discussions. As I said, in our very first meeting he highlighted this as an area where he wanted to see movement, and we are determined to get some movement.

We need the evidence base and we need trials to be ongoing to help inform future commissioning decisions. NHS England has also established a patient registry to collect uniform outcome data from licensed and unlicensed products. The refractory epilepsy specialist clinical advisory service has been established to provide expert impartial advice for clinicians treating complex cases while we await the outcome of clinical trials.

I hope I have managed to convey how committed I am, because I do believe that we ought to be able to find the solution for these children, and I was very aware of the hon. Lady’s point about what happens when they reach adulthood. My right hon. Friend the Member for Hemel Hempstead has spoken to me about the fact that as children move through and medicines gets better they thankfully survive longer, but then we have the added complexity of having to look at the system, which is why we want to make sure we find a solution. Finding the right solution is what we are after, because it will take time to generate further evidence and see the results of clinical trials. I do understand, however, that patients and families continue to access these medicines privately, and that the cost of doing so is very high. There are no easy or quick solutions, but I am committed that the Department will reconsider what action the Government may reasonably take with regard to access to unlicensed cannabis-based products for medicinal use where clinically appropriate.

The health of the children and adults dealing so courageously with these difficult-to-treat conditions is of paramount importance. I think it was Hannah who said to me that for every time Alfie does not end up in hospital having fitted repeatedly, there is a saving to the system.

[Alberto Costa]

Will my hon. Friend give way on that point?

[Jo Churchill]

Yes, finally, but then I am going to conclude.

[Alberto Costa]

My right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) made the point that the Government did supply the medication from a different Department, at no cost to the parents. I have suggested to the Minister that the Government, only on a temporary basis, should cover the cost for the very small number of children across the country who desperately need this medication, which they obtain through private prescription. Can she commit today from the Dispatch Box that she will at least try her best to find the money from her Department to cover those costs on a temporary basis?

[Jo Churchill]

I hope that I outlined earlier that a mixture of solutions is needed to crack this problem. We are not taking anything off the table. We are looking at every option that we can to ensure that we get the right support. Health is devolved, and the access to and funding of medicines is a matter for the relevant devolved nation. I hope, however, that hon. Members have seen that we are all trying to work on the challenge together, because there should not be a difference. As people have said this evening, this is not partisan; it is about making sure that we get the right care to the children.

I will commit that the health of children and adults is of paramount importance. It is of paramount importance to the Secretary of State and to me. I can assure hon. Members that I will carry on making sure, with my team, that we are doing as much as we can to try to get us to a solution that helps these children in the short term but also the long term, while having as the second strand of work the evidence base that we need to support the wider prescribing of any drug, because we need to make sure that we are doing it with care.

Question put and agreed to.

Cervical Screening

Jo Churchill Excerpts

Monday 19th July 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Pritchard.

First, as I think everybody else has done, I thank those who initiated this petition in Fiona Mathewson’s memory, and I join others in extending my sympathy to Andrew, to Ivy, to Harry, to Caitlin and to Fiona’s broader family, as well as to the 3,000 individuals in Kelso and across the borders who signed the petition.

Like other hon. Members, for example, the hon. Member for Pontypridd (Alex Davies-Jones), I know how frightening it is to be given this kind of diagnosis, but I can only imagine the impact on Andrew and the loss that he feels. However, if I may say one thing, it is that this debate today is in itself a huge legacy for Fiona, because we are discussing sensibly what we need to do to help women. We are talking, as many people have said, about something that is often seen as a little bit embarrassing. In response to the points by hon. Members that we must improve take-up, I could not agree more. However, we will not achieve that by not talking about some of the challenges that exist.

Cancer screening is crucial and I thank each and every Member who has shown their support for it and contributed to today’s debate. It was eloquently introduced by the hon. Member for Gower (Tonia Antoniazzi), as the Petitions Committee allowed us to have this conversation across the United Kingdom. The simple fact is that screening saves lives and that is why we need to drive uptake. As we have heard, screening can prevent cancer from developing. It can catch cancer earlier and, as we know, the earlier people are diagnosed the better the outcomes, because there is a greater chance that treatment can be successful.

Thanks to the tremendous work of dedicated screening staff up and down the country, the NHS cervical screening programme reaches about 4.6 million women in England every year and currently saves about 5,000 lives. However, we have heard repeatedly that only about 70% of women actually take up the opportunity, for a plethora of reasons. If everybody did attend, that number of lives saved would be closer to 7,000. More lives would be saved, so when a woman receives an invitation to attend a screening appointment, I encourage her to go.

As the hon. Member for Central Ayrshire (Dr Whitford) said, if you notice anything amiss, such as bleeding after sexual intercourse, between periods or during menopause, discuss it with a medical professional. Do not wait—it is your body and just treasure it. I say that because screening is one tool, but that knowledge of yourself is another tool that you have to access treatment quickly. NHS services are open, safe and ready to help you. That is another thing that has come through: I want to reinforce the fact that the NHS is open and the services are safe. You must come forward when your invitation for an appointment.

[Alex Davies-Jones]

The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) talked about some of the challenges faced by the lesbian and bisexual community in accessing appointments, but we also need to recognise some of the challenges faced by our trans community, especially trans men, in accessing appointments. Many of them are not sent reminder letters because of administrative policies at GP services. Will the Minister look into that to ensure that everyone with a cervix who is eligible to attend a screening receives a reminder?

[Jo Churchill]

Indeed I will. I would be happy to write to the hon. Lady, because I have looked at that issue. If there is a chance that someone may have abnormal cells, they should get them checked out. The hon. Member for Coventry North West (Taiwo Owatemi) spoke about making sure that we reach those communities who would not necessarily come forward, for a number of reasons.

The hon. Member for Wythenshawe and Sale East (Mike Kane) spoke, as several did, about using technology better, and about the challenges of screening and the health inequality that there is in certain communities for access to screening. I have met NHS England several times about that, to think how we can use that technology and different avenues—I will speak in a minute about the self-sampling sample.

We have to think differently about how we encourage women, because not every woman will come forward in the same way. We have different pressures on our lives at different times. Perhaps we are not as good at the younger end, because people think, as the hon. Member for Pontypridd said so eloquently, “I didn’t think it would happen to me.” Perhaps they have a young family or are busy at work. All those things mean that we have to make it as easy as we possibly can to access screening wherever you are and in whatever form suits you, because there are also cultural barriers for some not only to cervical screening but to breast screening, where they are hesitant to come forward.

[Jim Shannon]

I referred to my wife, who had some difficulty making the appointment. What she did was talk to my mum. I feel women talking to women is much easier. We should not always push to the back of the queue, for instance, a family member having a substantial discussion. Sometimes it starts with a discussion, before they go to the hospital. It very important to have family members around to support and give advice.

--- Later in debate ---

[Jo Churchill]

I could not agree more. We heard earlier that a good group of friends can give someone that nudge when they are feeling a little hesitant. As Members said, it is not the greatest outing of an afternoon, but it can be one of the most important appointments that you may keep, so I urge you to keep it.

I want to assure all women that screening staff are excellently trained to ensure that they feel reassured and comfortable. For those who feel anxious, there is information available online to help them plan their appointment. As many have done, I would like to commend the work of Jo’s Cervical Cancer Trust in raising awareness about what cervical screening entails and how important it is.

Let me turn to the nub of the debate—why screening is not offered on a yearly basis. Currently, cervical screening in England is offered to individuals between 25 and 49 every three years, and between 50 and 64 every five years. For those aged 65 and over, screening is offered if one of the last three results detected any abnormalities. Although health, including how screening is delivered, is a devolved matter, the debate has shown that wherever we are in the country, we need to ensure that health is a priority. We automatically transfer data on a woman’s history to the devolved authorities in Northern Ireland and Wales. I think it was the hon. Member for Gower who raised the question of how we work with devolved authorities: that information goes automatically to Wales and Northern Ireland, but it is still a manual process with Scotland, and work is in progress to make sure we get there.

As I have said, this matter is devolved, but as others have said, we all follow the expert advice of the UK National Screening Committee. The hon. Member for Central Ayrshire pointed out how important it is that we follow the advice of a central body, and in 2015, the UK NSC recommended that a test for HPV be used as the primary screen, because 99.7% of cervical cancers are caused by the high-risk HPV types. I could not agree more with one hon. Member—I apologise; I do not remember who it was—who said that we should talk about HPV in a normal, non-stigmatising way. We should have a conversation: it is important that we talk about those things that affect our bodies, to enable people to seek treatment and do something about them. If HPV is detected, you are referred for further testing. Cells are tested for abnormalities and, if present, you are tested again to see if treatment is necessary. If not, a follow-up appointment is always made for the following year, and if HPV is not detected no action is required, because it is highly unlikely that any abnormal cells are present and the chance of developing a cancer within five years is very small.

That process has been in place since December 2019, and since March 2020 in Scotland. It has made cervical screening more effective, improved detection rates and, crucially, requires women to be screened less frequently: there is a very salient point that the more often something is required, the risk that it is not taken up becomes greater. Making sure that we have the best tests at the best time interval, advised by the experts, is how we will proceed. However, that is not to say that all the technologies aptly described by the hon. Member for Wythenshawe and Sale East, as well as others that are available, are not being looked at all the time in all these areas. If there is a positive from the pandemic, it is that we have moved forward in many areas of technology, and as several Members have said, we need to harness that.

Given the strong link between HPV and cervical cancer, the national HPV immunisation programme is a key way to save lives. Introduced in 2008 and extended to boys in 2019, those vaccines have already led to dramatic reductions in HPV infections in England, and it is hoped that immunisation will eventually eradicate HPV and save hundreds more lives each year. The past year has been a challenging one, but as soon as the pandemic hit, we charged those in charge of the scheme with making sure that they had caught up with HPV vaccinations in schools by this August. They have used schools, community centres, and so on to make sure we do not fall behind on what is such an essential part of the programme—we know about the protection that it gives.

I do, however, acknowledge that screening is not perfect: HPV infection or abnormal cells can be missed, and can develop and turn into cancer between screening tests. That is incredibly rare, and the science supports the hope—I have this hope—that with the introduction of HPV testing and vaccination, many more cancers can be detected and prevented. The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) spoke of self-sampling, as did others. I am incredibly interested in this proposal. The YouScreen trial currently taking place in London is sending home-testing kits to some of those who have not taken up the offer of screening, making sure that we offer it to women who might find other environments difficult to be part of—because of time or a whole range of reasons—and who may prefer to do a simple swab test in their own home. That is what this trial is designed to do. It is particularly targeted at disadvantaged groups who may not have attended screenings.

As I say, there are busy lives, there is embarrassment and there are cultural barriers, so making sure we push that forward is important. There are plans for a nationwide trial to offer self-sample kits to women as an alternative to a nurse taking the sample. I have asked my officials to keep me informed of the trials. I eagerly await the UK NSC’s analysis once the trial is complete, and the subsequent recommendations on how self-sampling may be incorporated into the cervical screening programme.

I think we all agree on the need for women to come forward. I thank hon. Members for the tone of the debate and for how everybody expressed their concern that we make sure that we get to those women. I reassure people that, while we did indeed cancel those invitations early on in the pandemic, there is currently no national backlog of people waiting for an invitation to the NHS cervical screening programme. We have been working with and supporting providers to work above pre-pandemic levels to manage diagnostic backlogs. Waiting times for some appointments have increased in some areas, and in those areas specifically we are working with Public Health England’s screening quality assurance service and the relevant clinical commissioning groups. The problem is not everywhere, but I am aware that there is a problem in certain parts of the country.

I thank everyone for their contributions, and I express my sympathy—I know I speak for each and every Member here—to Fiona’s family and friends. The most effective way to prevent deaths from cervical cancer is for as many women as possible to attend their routine appointments, as opposed to yearly screening. Cervical screening undoubtedly saves lives, so once again: when you receive the invitation, please go, and if you notice any worrying symptoms in the meantime, contact your GP. NHS services are open, safe and ready to help you and help keep you safe. You have to help us by attending, so that the screening programme reaches as many as possible and we can drive that rate up into the sort of levels that mean we can prevent each and every woman from having what is, in effect, a preventable cancer.

Oral Answers to Questions

Jo Churchill Excerpts

Tuesday 13th July 2021 Commons Chamber

[Suzanne Webb (Stourbridge) (Con)]

What steps he is taking to tackle childhood obesity.

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

We are committed to halving childhood obesity in England by 2030, and the 2020 strategy takes decisive action to help everybody to achieve and maintain that healthier weight. We have five trailblazer sites working to create a healthy environment for our children. We have laid regulations for out-of-home calorie labelling. We have put £100 million into funding for adult and child weight management, and announced the introduction of some of the toughest advertising restrictions—both on TV and online—regarding children’s exposure to high fat, salt and sugar products. This is about the cumulative effect of several policies.

[Damian Hinds]

I am grateful to my hon. Friend for mentioning that wide range of measures. May I also encourage her to work closely with colleagues at the Department for Education and the Department for Digital, Culture, Media and Sport on an expanded children’s sports and activity plan, both in and out of school, to try to make 60 minutes a day as much a norm as five-a-day fruit and vegetables by bringing in the power of sports clubs and the governing bodies, and finally getting more school facilities available for out-of-hours use?

[Jo Churchill]

My right hon. Friend’s question is music to my ears. He will be pleased to hear that, last week, along with Ministers from DCMS and the DFE, I was in front of the Lords National Plan for Sport and Recreation Committee talking about doing just that—about how we can build on the DFE’s £10.1 million contribution, so that we can unlock the 40% of facilities that lie on school estates and help to get children active for 60 minutes a day. We will be publishing our cross-departmental update to the school sport and activity action plan later this year.

[Suzanne Webb]

Ultra-processed food is basically high in fat, high in salt and high in sugar, and it is highly addictive. I believe that it plays a significant part in the growing crisis that is obesity. I genuinely believe that it is not food in itself, when one considers all the flavourings and artificial colourings that have to go into it to make it taste like food in the first instance. Does my hon. Friend agree that the food industry needs to play its part in tackling the obesity crisis, and not contribute to it?

[Jo Churchill]

I do. This is about helping people and caring for people. We know the detrimental effect obesity has on all stages of our lives. It costs personally, in productivity terms, as well as the NHS, being the precursor to diabetes, heart disease, cancer, musculoskeletal conditions and so on. We cannot afford for the country not to tackle this issue. I am encouraged, but want to see business go faster in the reformulation ambition to reduce the salt, sugar and fat in these products.

[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.

[Mr Speaker]

Mr Zeichner has withdrawn, so let us go to the SNP spokesperson.

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

The Government’s plan to give pharmaceutical firms access to pseudo-anonymised data from GP practices in England is creating public concern and distrust, just like the failed care.data project of 2013. Most patients would be happy to see better communication and information sharing within the NHS, as well as for public health and academic research, but are concerned about commercial access to their data. Will the Minister halt the process to allow time for genuine debate and public consultation?

[Jo Churchill]

The hon. Member and I are both passionate about the use of data to enhance patient care, as she outlined. That is the prize here. We are listening. We are taking our time. The data will only be used for health and care planning and research purposes by organisations that have a legal basis and a legitimate need to use the data. NHS Digital will publish all the details of the data we have shared on our data release register. We want to build confidence. We want to build trust. We are listening, but this is an important agenda that we need to get right to deliver better care for patients.

[Dr Whitford]

The problem is that the plan to allow commercial access is going to undermine the public trust in improving digitisation within the NHS, and the Minister will be aware of that. The current plans apply only to the NHS in England, but can she guarantee that the United Kingdom Internal Market Act 2020 will not be used to force commercial access to patient data from Scotland’s NHS? If so, can she explain why the Department for International Trade is advertising access to the health data of 65 million people, which is the population of the whole UK?

[Jo Churchill]

I go back to the answer I gave: we do not allow data to be used for commercial purposes. NHS Digital will not approve requests for data where the purpose is for marketing and so on and so forth. The hon. Member would not expect me to respond on behalf of another Department, but I reiterate that we are communicating and building trust. There will be a public information campaign. We will be working across the professions and across research to make sure that access is appropriate and proportionate. In the Health and Care Bill, we will be redoubling our efforts to make sure people have that confidence.

[Alex Norris (Nottingham North) (Lab/Co-op)]

At the previous health questions, we secured a commitment from the Minister to delay the implementation date for this data grab in order to properly communicate with the public. However, rather than a significant delay so there could be the public information campaign the Minister says she is so keen to have, on the basis set out by the BMA and the Royal College of GPs, what we have instead is a short pause. The Minister says she wants to listen and to build trust, so why on earth is this being snuck out during the summer recess? The reality is that the Government simply have not passed the test for informed consent. Will the Minister take this moment today to stop this process and commit to a proper engagement campaign, rather than running off during recess?

[Jo Churchill]

I really respect the hon. Gentleman, but nothing is being snuck out. We are not doing a data grab. I refer him to the answer I gave a few moments ago. It is important that we get this right. We have heard the concerns and will respond to them. We will take the appropriate amount of time—even if that means going beyond 1 September—to ensure that we have engaged properly.

[Karl MᶜCartney (Lincoln) (Con)]

What evidence he plans to use to inform the Government’s decision on whether to proceed with step 4 of the covid-19 road map on 19 July 2021.

--- Later in debate ---

[Taiwo Owatemi (Coventry North West) (Lab)]

What steps he is taking to develop the role of pharmacies in primary care provision.

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

We are committed to the five-year community pharmacy contract and to enabling community pharmacy to deliver more clinical services as well as being the first port of call for minor illnesses. Pharmacists are highly skilled members of the primary care team. We are making good progress with referrals from NHS 111 and general practice, with discharge medicines services from hospitals, and with 96% of pharmacies providing lateral flow tests as well as delivering vaccines. We know that community pharmacies are keen to deliver more, and we should be thinking pharmacy first.

[Taiwo Owatemi]

I am sure the Minister agrees that pharmacies have gone above and beyond to deliver vital medicines and health advice to patients in their communities during the covid-19 pandemic and that their response underlines the huge potential to grow their already massive contribution to our nation’s health. Pharmacies have proven themselves to be a valuable member of the NHS family, so will she prioritise looking at the potential for pharmacies to provide even better primary care? Will she bring forward a plan to unleash their potential post pandemic?

[Jo Churchill]

I know that the hon. Lady speaks from experience, having been a clinical pharmacist before she came to this place. That potential needs unleashing. We are working across the profession to make sure that pharmacies are enabled to play a fuller part in the primary care family. We should think pharmacy first when we have minor ailments, and pharmacies should be enabled to do everything they can.

Public Health England: Relocation to Harlow

Jo Churchill Excerpts

Monday 12th July 2021 Commons Chamber

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

I am most grateful to my right hon. Friend the Member for Harlow (Robert Halfon) for securing this debate and for driving home so eloquently the three core threads of his argument. I pay tribute to him, to my hon. Friend the Member for Hertford and Stortford (Julie Marson), and, Madam Deputy Speaker, to you; your passion for your area overflows, and I know that you too have been acting and listening tonight for your constituents in Epping Forest.

Our experience of tackling the covid-19 pandemic has demonstrated, as my right hon. Friend the Member for Harlow said, the fundamental importance of an integrated health response in the United Kingdom. It has illustrated how critical it is to bring together scientific and public health expertise with operational agility. It has underlined the importance of public and private sector collaborations to deliver world-class science and innovation. Getting this right, as my right hon. Friend outlined, is critical to the future security of the nation, and it has arguably required a fundamental rethink of how the public health system and the national health service will work together.

The establishment of the UK Health Security Agency and the Office for Health Promotion are crucial to this new way of working. I am going to focus on the UK HSA, because that is the organisation that has a distinct bearing on what we are talking about this evening. Public health transformation is happening at pace and the UK HSA will be fully operational by October. It will focus on protecting the public’s health and ensuring health security for the nation. It will prevent threats by deploying the UK’s scientific, genomic and analytical capabilities to tackle infectious diseases and public health hazards such as the one we have faced in the past 18 months. It will be science-led, maintain the highest science and research standards and respond to the threats that may come upon us at pace and scale.

Our immediate priority is to manage the current delta variant while working to ensure that UK HSA has solid, firm foundations. Part of that work is to ensure that the underlying operating model for the national science hub is the right one. UK HSA is responsible for the science hub initiative. The principle remains to deliver a step change in public health science and research capabilities with genuinely world-leading facilities that, as the House would expect, we need to ensure are sustainable in every sense of the word.

I am aware that, prior to UK HSA’s creation, one of the key reasons for considering the campus at Harlow was its strategic location, as so eloquently laid out by my right hon. Friend the Member for Harlow and his parliamentary neighbour my hon. Friend the Member for Hertford and Stortford. As we heard, it is wonderfully placed in the east of England, near to major cities and close not only to the vibrant life sciences industry that my right hon. Friend spoke about but to some of the key aspects of academia.

Throughout the UK we currently have a number of leading centres for life science research and innovation. As my right hon. Friend pointed out, the UK Innovation Corridor between London and Cambridge is one of the fastest growing in Europe and something of which we should be proud as a nation. It is widely recognised in the key areas of genomics and data science. With academia, the Wellcome Sanger Institute and leading multinationals we have the rich environment for academic and commercial partnerships to which my right hon. Friend referred. As we have seen in the development of the Oxford-AstraZeneca vaccine, such partnerships are critical to the future success of the public health response here in the United Kingdom.

As a town, Harlow has ambitious plans for the future and for levelling up. As my right hon. Friend said, it has potential to realise. That lies at the heart of the Innovation Corridor, and anchor institutions play a vital role. As my right hon. Friend said, Harlow recently won support worth over £23 million to underpin local regeneration projects. The local garden town development will bring new housing and improved transport. Further Government support is being sought that, if successful, could take investment for Harlow to over £100 million. Alongside that, the Princess Alexandra Hospital in Harlow is at the vanguard, being one of the six hospitals in the Government’s ambitious hospital building programme. There is definitely a bright future for Harlow. The science hub programme is working with my Department to support the transformation in public health. This will take into account learning so far from the pandemic response and the implementation of the UK Health Security Agency.

In conclusion, I congratulate my right hon. Friend the Member for Harlow on his judicious timing of this debate, coming as it does ahead of recess and in the run-up to the official establishment of the UK Health Security Agency in October. I know that his backing for science to be centred in Harlow will be heard and I am sure that we will go on to have further discussions on this interesting topic.

Question put and agreed to.

Desogestrel Contraceptive: Availability from Pharmacies

Jo Churchill Excerpts

Thursday 8th July 2021 Written Statements

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

I am pleased to announce that officials in the Medicines and Healthcare products Regulatory Agency (MHRA) have granted two marketing authorisations to allow the supply through pharmacies of the progestogen-only oral contraceptive—desogestrel—as an over-the-counter medicine. This follows a rigorous review of the safety of this medicine by the Commission on Human Medicines and a public consultation. The response to the public consultation which was carried out as part of the regulatory assessment is also being made publicly available today. The MHRA has a long-established process for reclassifying medicines from prescription-only status to being made available for purchase over the counter when it is safe to do so.

This landmark reclassification, which was widely supported by women and healthcare professionals in the recent consultation, will enable women to purchase a progestogen-only contraceptive from a pharmacy following a detailed consultation with the pharmacist. This will provide an additional route to access for those seeking contraceptive services and will help to reduce the pressure on GP surgeries and sexual health clinics with the potential to reduce the risk of unplanned pregnancies and abortions. Pharmacists already provide a range of services in the area of sexual and reproductive health and are trained practitioners who are experienced in checking eligibility for all the products they supply.

The reclassification of desogestrel to a pharmacy medicine supports the Government’s wider commitments to improve women’s health and to ensure the public receive the best possible sexual health and contraception services. A new sexual and reproductive health strategy and a new women’s health strategy in England are in development, to be published later this year. The women’s health strategy will have an overarching aim of improving the health and wellbeing of women and the sexual and reproductive health strategy will set out ambitions to reduce inequalities in sexual and reproductive health outcomes, and will include a focus on improving reproductive health and access to contraception.

This reclassification is therefore an important step towards meeting our ambitions to improve women’s health by widening access and providing women with more choice in the provision of safe and effective contraception. Progestogen-only contraception will continue to be available free from prescription charge from GPs and sexual and reproductive health services as is the case for all prescribed contraception.

[HCWS158]