Medical Implants (EU and UK)

Debate between John Pugh and Jamie Reed

Wednesday 6th March 2013 Commons Chamber

[John Pugh]

I am coming to that, Mr Deputy Speaker. In a way, that illustrates my point, because what we are actually debating is the supplementary estimate. My hon. Friend the Member for Gainsborough and I were tasked with looking at how the House debates supplementary estimates, and the answer we came to was this: not very well. Our report, a copy of which is in the Library for hon. Members to consult, testifies to that finding, and we produced adequate evidence for it, because the report was co-ordinated to some extent by the Treasury, which keeps a close eye on these things. I am suggesting that the work of examining the nation’s finances is boring, dull and, at times, anorakish, but it certainly needs to be done, and it probably should be done by Parliament, and on occasions like this.

[Mr Jamie Reed (Copeland) (Lab)]

On that point, which the hon. Gentleman is making very well, can he recall when the House last divided on an estimates debate?

[John Pugh]

I certainly cannot. There are occasions when we talk about general topics, but I think that I am right in saying that the reasons we have estimates days is so that Parliament, as well as the Treasury, can scrutinise the nation’s accounts. I regard that as highly desirable in this age of austerity, when we need to count every penny and record the overspend, underspend, virement and so on.

I will now turn to the subject that appears to be the subject of this debate but is not actually on the Order Paper: medical devices and implants. I would like to make a few observations on what the hon. Member for Ellesmere Port and Neston (Andrew Miller) calls post-market surveillance, which we agree needs to be improved. That is obviously wholly desirable because it will eliminate problems, improve patient security and so on. I would not disagree with a single word voiced by him or his Committee. I agree that there should be more transparency and more feedback from patients and clinicians so that devices are safe and do exactly what they are supposed to do. However, we can improve regulatory vigilance. The MHRA has done a good job so far, but it obviously could do better. There is clearly a role for increased manufacturer responsibility. That is all very important.

The simple point I want to make about implants—I am not allowed to talk about the huge sums of money we are voting through—is that detecting failings is quite a complex matter. It is not as simple as it was with the breast implants, which was a case of the wrong substance being provided, which is fraud. I will illustrate my point with a real-life example. I am familiar with a case in Nottingham involving a number of unfortunate episodes that followed heart surgery in which a particular type and brand of stent was used. A number of people were called back for second operations because the stents leaked. I believe that there were a number of deaths and some litigation. Initially it was thought that the device was at fault, because it looked as though the people who had the device experienced certain problems and complications, and there had been other problems with it elsewhere. It was subject to a court case and prolonged investigation. Ultimately, the blame was attributed—this bears out the point made by my hon. Friend the Member for Truro and Falmouth (Sarah Newton)—to the surgical procedure, rather than to the device itself.

Therefore, there is a particular problem when it comes to post-market surveillance. Is it the equipment or how it is used that is responsible, because the equipment is only as good as its user? That is a particular issue in surgery, because surgeons up and down the land are very particular about what bits of kit they use and what type of equipment they work with.