Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 13th January 2015 Commons Chamber

[Mr Mark Spencer (Sherwood) (Con)]

13. What progress his Department has made on its long-term plans for easing pressures on A and E departments and preparing the NHS for the future.

[Julian Sturdy (York Outer) (Con)]

15. What progress his Department has made on its long-term plans for easing pressures on A and E departments and preparing the NHS for the future.

[Henry Smith (Crawley) (Con)]

16. What progress his Department has made on its long-term plans for easing pressures on A and E departments and preparing the NHS for the future.

--- Later in debate ---

[Mr Hunt]

I am aware of the problems with that deal, signed back in 2005, which is now consuming 17% of the trust’s income. It would like to spend that income on more doctors and nurses, but it cannot because of the shockingly bad deal signed. I would be happy to meet my hon. Friend to discuss what is possible in the current circumstances.

[Julian Sturdy]

There are many causes of the pressure on A and E, and in more rural areas direct access to services can be difficult and costly. As such, will the Secretary of State consider investing further money in new technologies that could drive a revolution in health care facilities, and if such opportunities present themselves, may I promote York and north Yorkshire as an ideal testing ground for these technologies, given its ageing population and rurality?

[Mr Hunt]

I remember my hon. Friend’s campaigning on superfast broadband in north Yorkshire from my last portfolio. He is absolutely right that technology has a big role to play. That is why a year and a half ago the Prime Minister announced plans to expand weekend and evening GP appointments through the use of technology, which is already helping 5.5 million people and by March will be helping 7.5 million people. We must absolutely consider this as a solution.

NHS Funding (York and North Yorkshire)

Julian Sturdy Excerpts

Wednesday 7th January 2015 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a privilege to serve under your chairmanship, Mrs Riordan. I am delighted once again to have secured an opportunity to address the important issue of health care funding in York and North Yorkshire and, ultimately, the formula used to calculate the per patient funding from which clinical commissioning groups—and, before them, the primary care trusts—derive their money. Other North Yorkshire and York MPs and I have been campaigning on this issue since 2010, and I am delighted that my hon. Friends the Members for Skipton and Ripon (Julian Smith) and for Harrogate and Knaresborough (Andrew Jones) are here to support me this afternoon. I strongly believe that the nettle has to be grasped on what I accept is a difficult issue, albeit one that cannot continue to be ignored.

The quality of local health care is of the utmost importance to many, if not all, people because, ultimately, it is something upon which we all come to rely at some point in our life. Health care provision is a measure of the local community’s economic well-being and happiness, and it is in our moral and economic interest to ensure the widest availability of health services, the shortest waiting lists and that the most impressive health outcomes are available to all, which I stress. Ensuring such health care standards for all is truly one of the Government’s most essential roles. Indeed, I am sure that all hon. Members from North Yorkshire, both those who are here and those who are not, will agree that health-related concerns crop up frequently in our constituency mail. That is certainly the case in my constituency, as I am sure it is in yours, Mrs Riordan. As such, I welcome the £2 billion of health care spending promised by the Government for this financial year in the autumn statement. That injection of cash has led to every area’s budget increasing ahead of inflation in the recently released allocations. It is for such reasons that I believe the Government can stand proudly on their NHS funding record.

I have called this debate, however, to address the fair allocation of funding and the impact on health care delivery due to a funding formula that works to my CCG’s disadvantage. In a previous debate on this issue I outlined my concern that the now-abolished primary care trusts would pass on their historical debts to the new CCGs. Vale of York CCG inherited a deficit of some £7 million in April 2013 due to the current funding formula. NHS England has acknowledged that the previous York and North Yorkshire PCT received approximately £17 million less than the allocation should have provided for the local population demographic because the funding is phased in over time. Although I am pleased to say that Vale of York CCG has cleared the deficit it inherited, it is still struggling to offer many services that constituents have a right to expect. Allocations made for the newly formed CCG in 2013-14 were a straight uplift of the historical allocations, which resulted in a postcode lottery for certain health care services in my area.

Why does Vale of York CCG, in particular, receive such a poor allocation? The Government decide how much money should be allocated to each CCG. Officials begin by dividing the total budget by the number of people living in each respective area. Money is then added or taken away to account for local characteristics, including the proportion of people claiming benefits, the teenage pregnancy rate and the number of people who leave education early. That is where the problem lies. Of the 10 characteristics, nine reduce the amount of money allocated to our area. That disparity in the allocation is due to the funding formula failing to take account of both the rural nature of the region and, most importantly, age. Instead, the current formula provides a significant weighting that awards additional funds to areas with high levels of social deprivation. The allocations for 2015-16 have now been announced and, once again, Vale of York CCG has received, by a substantial margin, the lowest per capita funding of all the CCGs in the area. Although I recognise that health needs are generally greater in more deprived areas, the current formula provides far too much weighting for deprivation and insufficient weightings for age and rurality.

Age and rurality are even greater problems in my constituency and in other North Yorkshire constituencies because York and North Yorkshire have the highest proportion of over-85s in the north, but Vale of York still receives among the lowest funding per head of any northern CCG. The area also has a high number of people in care homes, with a typical GP practice informing me that up to 50% of home visits are taken up by care home residents, who account for only 2% of patients on the practice’s roll. The distribution of health care costs is strongly age dependent, and it is difficult to argue against that. On average, it costs approximately eight times more for the NHS to care for a patient over 85 than for a patient in their 40s, which, of course, is due to elderly people being more likely to have additional health problems. We are all living longer, which is obviously a good thing, but we are living longer with more complicated conditions. Age is increasingly becoming a defining factor in health care funding.

Alongside age, the formula does not account for the additional cost of providing health care services in sparsely populated rural areas. Those additional costs are reflected, among other things, in longer average journey times for ambulances and community health staff, such as health visitors. There is also a need to provide additional smaller hospitals in rural areas in order to retain accessible and essential services for those communities.

The distortion in the funding formula has led to certain areas being awash with money, which in the past has sadly led to well publicised vanity health care projects, whereas York and North Yorkshire have consistently struggled to balance the books, resulting in their continuing to take difficult decisions on health care provision. Those decisions have had a massive impact on the quality of life of many of my constituents, hampering their ability to work and affecting their careers.

To my mind, Vale of York CCG does not provide some procedures due to the funding formula. I have been contacted by many constituents over the past few years regarding their inability to receive pain-relief injections free on the NHS. I have been actively campaigning for the removal of those charges for all who require such injections. I am sorry to say that the charges are symptomatic of the postcode lottery due to the current funding formula. The CCG reviewed its position on pain-relief injections and concluded that the injections are not clinically beneficial, which is why it decided to retain the charge, but I would argue that the injections can dramatically improve people’s quality of life and should be offered free of charge. Pain-relief injections are offered free of charge by many other CCGs across the country and across our region.

Alongside pain-relief injections, another procedure that has not been available through the Vale of York CCG is IVF treatment. In fact, for a long time the Vale of York was the only health authority in the country not to offer any free IVF treatment. I know from many constituents who have contacted me about the issue that infertility has an awful effect on people’s lives, causing stress and depression, and with the potential to tear otherwise healthy relationships apart. It must be extremely frustrating for someone to know that treatments are available just a few miles away but are inaccessible to them; nevertheless, that has been the reality in many parts of my constituency for a number of years.

I was pleased to hear the CCG announce in late December that it will now offer at least one cycle of IVF. Although that falls well short of the three cycles recommended by NICE, it is a welcome step in the right direction.

[Miss Anne McIntosh (Thirsk and Malton) (Con)]

I apologise to my hon. Friend for missing the start of his speech and congratulate him on securing this debate. This may tempt him toward a conclusion, but does he agree that spending more on primary care in the Vale of York and other North Yorkshire CCGs would keep people out of hospital, which would obviously be to the greater good of the health service and those living in North Yorkshire?

[Julian Sturdy]

I entirely agree with my hon. Friend. Given the rurality of the whole of North Yorkshire, which I mentioned at the start of my speech, we know that providing health care services is difficult and expensive. That is part of the argument for why the funding formula must be adjusted. At the same time, it must be more cost-effective to deliver services in people’s homes and offer more accessibility. Nevertheless, as my hon. Friend will know from the situation in her constituency, it is important that we also keep small hospitals open and accessible. I know that that is an important issue in the constituency of my hon. Friend the Member for Skipton and Ripon. This debate is all about ensuring that we have a fair formula so that we can deliver those services.

[Julian Smith (Skipton and Ripon) (Con)]

On that point, when we are here in London it is difficult for people fully to comprehend the distances involved for both patients and their families in North Yorkshire. The local provision from the hospital in Ripon and Castleberg hospital in Settle in my constituency is valued really highly by families and patients alike.

[Julian Sturdy]

My hon. Friend is absolutely right that that is fundamental to a fair health care system and to fair health care for all. Through this debate I want to show how important that is for our area. We need a fair funding system that can deliver health care across not only York and North Yorkshire but the whole country. We must ensure that areas such as York and North Yorkshire do not suffer while others benefit. That is why we must get the funding formula revised.

Returning to IVF, the treatment now offered by Vale of York CCG does not help those who have been denied access to treatment, as have many people in my constituency over many years. They have either paid thousands of pounds privately or are now past the eligible age criteria for access to IVF. Despite that welcome news from the CCG, people living in our area had no access at all to IVF treatment for some time.

Alongside certain procedures that have been denied to many of my constituents, another area that has really felt the strain is A and E, which has hit the headlines in the past 24 hours. I wholeheartedly welcome the Government’s £700 million increase to the NHS budget to deal with well-known winter pressures. That shows the Government’s foresight: they knew that the issue was looming and so put that money in. Nevertheless, altering the funding formula would also help areas that are constrained by their budgets, because A and E funding ultimately comes through CCGs.

Finally, I want to turn to the controversial issue of clinical exceptionality and the impact that it has had on several of my constituents. Where a treatment is not routinely commissioned by the local health authority, clinicians must submit individual funding requests on behalf of their patients, which are then decided by a special panel. In order to achieve funding, the GP is required to prove that their patient is clinically exceptional from the referenced population. Or, to put it more plainly, they must be suffering more than other sufferers of the same condition.

That is, just as it sounds, an extremely difficult task for already busy GPs. It also results in an extremely tragic situation wherein a small group of people who suffer with a rare condition slip through the net and do not receive the treatment that their doctors feel that they need. Their condition is too rare for the particular treatment to be routinely commissioned, but not rare enough to prove that they are clinically exceptional and therefore eligible for individual funding.

One young constituent of mine suffers with severe gastroparesis, as well as diabetes. His devastating condition effectively prohibits his stomach from doing the job that it is supposed to do. As a result, he feels almost permanently nauseous and vomits up to 30 times a day. His clinicians believe that the most effective treatment for him is to have a gastro-pacemaker fitted at a cost of £25,000. That may seem like a lot of money, but as my constituent is unable to work and his mother has had to leave work to care for him, the cost to the state is far greater each year. The alternative treatments that he currently receives, such as morphine, also come at great cost to his health and well-being.

I have been working for some time on behalf of my constituent and alongside his clinicians to try to obtain the necessary funding for the treatment he so badly needs. The most frustrating thing for him is to know that other patients under the same clinicians, who do not suffer as badly as he does, are being accepted for funding because they live in areas that do much better out of the existing formula than York. Sadly, I fear that the lack of funding in our area is causing the individual funding request panel to interpret the rules of clinical exceptionality much more rigidly than our neighbours in, for example, Leeds.

My nine-year-old constituent Ben Foy, of Strensall, has also been a victim of the deeply unsatisfactory situation. Ben suffers with narcolepsy and cataplexy after having the swine flu vaccine, and he is known to fall asleep suddenly up to 20 times a day. Along with Ben’s family and clinicians, I have tried numerous times to obtain funding for sodium oxybate to treat his condition, but we were repeatedly told that we had fallen short of proving his clinical exceptionality.

To sum up, as it stands the funding formula is clearly causing a disparity in how health care is delivered across Yorkshire, as well as across the country. It is imperative that we move toward a funding formula that gives much greater weight to age and that recognises rurality and its associated higher cost of health care provision, while scaling back on the amount given for deprivation. We cannot continue to have, as was previously the case with PCTs, CCGs in the deprived areas of Yorkshire and the Humber receiving substantially more per capita and consistently under-spending their allocation, at the expense of CCGs in areas such as mine. Time and again, we are seeing patients being refused or pushed away from treatment because of the funding formula.

Ultimately, I accept that it is a difficult decision for the Government, the Department of Health and the Secretary of State. Along with colleagues, I have met the Secretary of State and Ministers numerous times to discuss the issue. As I say, I know that it is a difficult decision, but I fundamentally feel that we have protected the NHS budget during the past five years and we have seen more money go into the NHS over that time, which is the right thing to have done, but now we must ensure that we have a funding formula that backs that investment up and can deliver a fair health care system for all.

Antibiotic Resistance

Julian Sturdy Excerpts

Wednesday 15th October 2014 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

I am delighted to have been given the opportunity to host a vital debate on antibiotic resistance. As ever, Mr Chope, it is a pleasure to serve under your chairmanship.

Many people will be aware that the 20th century discovery of antimicrobial drugs, a class of medicine that includes antivirals, antimalarials and antibiotics, such as penicillin, is among the greatest medical breakthroughs of our time. However, we have failed to heed the warnings of such people as Alexander Fleming, who, when collecting his part of the Nobel peace prize in 1945, warned:

“there is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant”.

There has never been any doubt about the link between the misuse of antibiotics and resistance to them, but despite this antibiotics have been misused and, as a consequence, we now face the prospect of losing modern medicine as we know it. If people take a moment to think about the consequences, they will find them frankly horrifying.

In 2013, the chief medical officer, Professor Dame Sally Davies, told Parliament of an horrific scenario, where people going for simple operations in 20 years’ time could die of routine infections because

“we have run out of antibiotics”.

To some, this scenario may still seem too far in the future to warrant any immediate action, but for me the clock started ticking on this issue a long time ago. Yet we are no further forward.

In 20 years’ time, my children will be in their late 20s. Parents and families around the country will all want their children, and the next generation after that, to have the medical guarantees that we have the luxury of being afforded today, so inaction is simply not an option.

Antibiotic resistance is already changing clinical practices in this country, For example, in recent years complication rates for prostate biopsy, which carries a risk of septicaemia, have increased from less than 1% in 1996 to nearly 4% in 2005. Due to this, doctors are now carrying out the biopsy in a different way, changing clinical practice.

The rise of antibiotic resistance is widely seen by organisations such as the European Food Safety Authority and the World Health Organisation as a consequence of the use and overuse of antibiotics in both veterinary and human medicine. However, in this debate I will focus on the continuing overuse of antibiotics in human medicine, where considerable improvements could still be made in many countries.

[Mr David Davis (Haltemprice and Howden) (Con)]

I congratulate my hon. Friend on securing a debate about one of the great threats to modern civilization: the prospective failure of antibiotics. Since he is not going to focus on agriculture, might I ask whether he agrees that, because some 50% of antibiotics are used in agriculture in this country, and 80% in the United States, if we are to take an international lead, as the Prime Minister would wish us to, we have to clean up our own act at home, in the way that the Dutch have in agriculture?

--- Later in debate ---

[Julian Sturdy]

I agree. Although I was only going to touch on that matter briefly, that does not mean that I do not recognise the impact on resistance from use of antibiotics in veterinary medicine. My right hon. Friend is right to mention the problems relating to resistance in the US, especially because the way that veterinary antibiotics are used there is quite frightening. In the UK and Europe, we use antibiotics differently. The Dutch are the example in that regard, and we have to learn from that. If we continue to misuse antibiotics, whether in human medicine or in the veterinary industry, resistance is bound to happen and that is bound to cause a problem, so we have to tackle it on both sides, although I want to focus on the human medicine side.

[Jeremy Lefroy (Stafford) (Con)]

My hon. Friend mentioned malaria and the treatments against it that have been discovered. He may know that, through misuse of the latest generation of artemisinin-based antimalarials, resistance to those is already coming up through Thailand and Burma and will possibly, eventually, get to sub-Saharan Africa, with devastating consequences, as was the case with previous antimalarials.

[Julian Sturdy]

My hon. Friend is right. I was going to touch on that. Multi-resistance is widespread around the world. He mentions antimalarials, but resistance is also apparent in relation to tuberculosis and there is emerging resistance to the antibiotics of last resort—the so called super antibiotics—the carbapenems, which are not licensed for use in farm animals on the veterinary side. That resistance is causing real concern.

Returning to the livestock sector for a minute, there is a tendency among some sections of the intensive livestock industry, and even some Governments, to dismiss almost entirely the contribution to resistance by veterinary use of antibiotics. This is a dangerous path to take, because although antibiotic use in farm animals may not be the main driver of resistance in humans, it is a still an important contributor, and we must recognise that.

[Glyn Davies (Montgomeryshire) (Con)]

Before my hon. Friend moves away from the agricultural sector, let me say that, in a long previous life as a livestock farmer, one of my earliest experiences was of the most amazingly casual approach to the use of antibiotics. If we are going to change the mindset in the agricultural industry, we have to bring on board the unions that advise farmers and get the people running agriculture onside in recognising the danger of this, because an awful lot of individual operators just do not accept the dangers and risks.

[Julian Sturdy]

I agree entirely with my hon. Friend. I said earlier that we must tackle misuse in the livestock sector, as well as misuse in human medicine; we must tackle misuse across the world. Regarding food security and imported food, antibiotics are misused throughout the world in the livestock sector.

It is worth putting on the record that in the UK we have some of the best animal welfare standards in the world, but we do not misuse antibiotics to any extent in the food chain, as is seen in the US. Such misuse has to be stopped and action has to be taken on that.

For far too long antibiotics have been used as if they were a bottomless pit of cure-all miracle treatments. Some 30 years ago, the battle against infectious diseases appeared to have been won, at least in the developed world. The old drugs could handle whatever bugs came along, which meant there was no market for new ones. That is why, since the year 2000, just five new classes of antibiotics have been discovered, and most of these are ineffective against the increasingly significant problem posed by gram-negative bacteria, which are also difficult to detect. The fact is that misuse, over-prescription and poor diagnostics have driven an environment that favours the proliferation of resistant strains of bacteria, rendering once vital medicines obsolete.

[Mr Iain McKenzie (Inverclyde) (Lab)]

I congratulate the hon. Gentleman on securing this important debate. What does he think about the growing pressures on GPs from their patients to prescribe antibiotics, which causes over-prescription?

[Julian Sturdy]

The hon. Gentleman makes a valid point. I hope that, through this debate and beyond, we can get the message out there that the misuse of antibiotics is potentially the greatest threat to mankind that we have seen, and in doing so, I hope that the pressures on GPs will start to subside. He is absolutely right. GPs in my constituency tell me that as soon as some people get a common cold or a sore throat they are breaking down the door, asking for antibiotics. Sometimes it is difficult for GPs to resist those calls. If we are going to secure our long-term future in the medical industry, those calls have to be resisted and that is where it has to start.

If we look at deaths related to MRSA, which is a bacterial infection resistant to a number of popular antibiotics, mortality rates rose steadily in the UK from 1993 onwards to peak at more than 2,000 in 2007. Bacteria and parasites are already developing resistance to front-line antimicrobials, which are over-prescribed and under-regulated, leading to 25,000 people dying each year in Europe from infections that doctors were unable to treat with the drugs available to them. Those statistics, however, are just from the developed world; the misuse of antibiotics is a much more serious problem in lesser developed countries, as my hon. Friend the Member for Stafford (Jeremy Lefroy) said. Hotspots of antimalarial-resistant parasites are springing up in south-east Asia, as are cases of extreme drug-resistant tuberculosis in South Africa and other parts of the African continent. Those are among the many examples that illustrate the urgent nature of this health problem.

In an increasingly interconnected world, an infection that emerges in Delhi today will have an impact in London tomorrow. More needs to be done on a scientific level to develop new antibiotics and to improve diagnostics, but science alone will not solve the problem. Pharmas, which is the collective term for pharmaceutical companies —I put on record that I was a farmer, not a pharma—need to be incentivised to develop new antimicrobials. As with other resources, antibiotic effectiveness can be used up. The eventual loss of current antibiotics is sadly inevitable, but, depending on the actions taken now, it can happen at a much slower pace.

While there are many examples of misuse in lesser developed countries, I want to look specifically at the case of India, as the challenges associated with controlling antibiotic resistance there are many and multifaceted. India has a problem with the overuse and underuse of antibiotics. The underuse is mainly due to the lack of prescriptions. For example, prescriptions were not presented for one fifth of the antibiotics purchased recently in Delhi. However, in 2005-06, a large proportion of infant and childhood deaths from pneumonia would not have occurred if the children had been properly treated with antibiotics. On the overuse, patients with coughs and colds are often prescribed antibiotics, which wastes their effectiveness. As I said, many continue to purchase antibiotics without a prescription.

India has emerged as the world’s largest consumer of antibiotics, with a 62% increase over the past decade. They consume an average of 11 antibiotic tablets a person a year—that is five days of antibiotics for every person in the country. Additionally, the use of last resort drugs such as carbapenems has gone up significantly. That is due to the enzyme known as NDM-1, which makes bacteria resistant to a broad range of antibiotics, including the antibiotics of the carbapenem family. Bacteria that produce carbapenemases are often referred to in the media as superbugs, because the infections they cause are difficult to treat. In India, 50% of all superbugs are resistant to all known antibiotics. The only exception to that is colistin, but that is because the antibiotic, which was introduced in 1959, is considered toxic.

In India, it is commonplace for someone with a sore throat to go to the chemist and choose the antibiotic they want to use. From there, many people will go to a clinic and are given their chosen antibiotics intravenously to treat the sore throat. Usually, the full dose is not administered. That is a horrendous example of the misuse of antibiotics and simply cannot be allowed to continue. Over-the-counter regulation needs to be tightened in lesser developed countries and people need to be better educated on the problems associated with misuse.

On funding and bringing new drugs to the marketplace, when pharmaceutical companies are deciding where to direct their research and development money, they naturally assess the market for a drug candidate. They have an incentive to target diseases that affect developed countries, because they can afford to pay. The pharmas also have an incentive to make drugs that many people take, and take regularly for a long time, such as statins and antidepressants, which leads to enormous under-investment in certain kinds of diseases and certain categories of drugs. Diseases that mostly affect poor people in poor countries are not a research priority, because it is unlikely that those markets will ever provide a decent return. That problem can still be seen with antimicrobials. Again, the trouble is the business model. If a drug company invented a powerful new antibiotic, Governments would not want it to be widely prescribed, because the goal would be to delay resistance. Public health officials would, appropriately, try to limit sales of the drug as much as possible. That makes for good public health policy, but a bad investment prospect.

As we all know, pharmaceutical companies form a major part of how the problem can be addressed, but we have to keep regulation in mind. By that, I mean the ability to identify infected patients quickly and cost-effectively and, indeed, to identify whether antimicrobials are needed at all. Failure on that is a root cause of the blanket drug usage we are seeing around the world. Surveys in the UK have shown that many doctors, as the hon. Member for Inverclyde (Mr McKenzie) said, still prescribe antibiotics far more often than necessary, and they are often under intense pressure to do so. A significant number of patients fail to complete a full course of antibiotics, and I hold my hands up and say that I have done that, as I am sure have many other Members. As resistance becomes more commonplace, it increases the chances that the initial antibiotic prescribed will be ineffective. As a result, resistance to antibiotics, such as carbapenems, has grown from five patients in 2006 to 600 in 2013.

While improved diagnostics would increase the effectiveness of the antimicrobials already available, the need to develop more sophisticated drugs that can keep pace with resistance is critical. The development of new drugs, however, will only come when pharmaceutical companies invest once again in antibiotics. That will occur only when those companies know they can recoup their investment costs. Of the 18 to 20 pharmaceutical companies that were the main suppliers of new antibiotics 20 years ago, just four persist in the field. Ultimately, given the choice between making an antibiotic that a person might take for two weeks once in a lifetime or developing an antidepressant that a person would take every day for the rest of their life, pharmas will naturally opt for the latter. It is thought that we need some 200 new antibiotics to cope with the growing problem. However, pharmas are clearly wary of funding this type of investment if the scope for use afterwards is limited.

I originally believed that the best way to tackle the problem would be for the Government to agree a decent unit price for antibiotics. However, it is likely that pharmas would not trust the Government—of whatever colour or combination—to deliver on that promise, so the best option could be to let the market handle the unit price, meaning that Government would stop restraining the price of antibiotics and allow them to increase to entice pharmas to invest. The more I have researched the topic, however, the more convinced I have become that that idea would not succeed. Introducing a targeted antimicrobial and selling it for the price of a cancer drug is likely to be impossible, because this is a market where people are used to getting antibiotics for next to nothing. Why would they suddenly start paying such high prices? As a result, the best solution may be incentives. The key would be to reward companies for creating substantial public health benefits, and the simplest way to do that would be to offer cash prizes for new drugs. For example, the Government would make a payment to the company, and the company would in exchange give up the right to sell the product. That would ensure the pharmaceutical company would be paid, and it would avoid all the expenses of trying to push a new product, as touched on in a report by the Select Committee on Science and Technology.

Additionally, Governments could use the approach that worked with vaccines and new pre-purchase antimicrobial drugs for a set number of years. Such pre-purchasing agreements would mean that the health care system becomes responsible for the proper usage and surveillance of antimicrobials. Currently, no Government grants are aimed at antibiotic discovery, but I welcome the independent review into antimicrobial resistance that the Prime Minister announced in July. I also welcome the brilliant news that the public recently voted to focus the new Longitude prize on antibiotics. The money will go to whoever can develop a rapid bacterial infection diagnosis test within five years. Announcements such as that ensure that antimicrobial resistance is kept in the news and on people’s minds.

Another way to ensure progress is to set up a global organisation that focuses solely on antimicrobial resistance. The World Health Organisation is now devoting considerable time to the problem, but it only produced its first global report in April this year. We are entering a perfect storm with no global organisation or global pharmas tackling the issue head on. Ultimately, a global network needs to be created to fund global antibiotic discovery. In addition, we need to ensure that people are aware of the problem and how it can be solved. Only with the public’s interest can we rally enough support to ensure antimicrobial resistance stays at the top of the political agenda, which will ensure that action is finally taken.

Overall, the purpose of today’s debate is to raise the profile of the devastating threat of antimicrobial resistance and hopefully to strike a chord across the House. Solving the problem will not be easy and will take considerable time. However, if we do not act now, things will only get worse. Many people in positions of authority in the medical profession consider antimicrobial resistance to be one of the biggest threats to mankind and I agree with that assessment. Therefore, I would like to outline a three-step plan to the Minister, which is essential to tackle the problem head on.

First, I have always believed that an in-depth report is needed into antimicrobial resistance. As such, I am extremely pleased by the Prime Minister’s announcement in July that a report will be carried out by the renowned economist Jim O’Neill. The report will look at the increase in drug-related strains of bacteria; market failure, which is crucial; and the overuse of antibiotics globally. Secondly, a global network needs to be created to fund global antibiotic discovery. Finally, the Government must step up and support small companies that invest in antibiotic discovery. As the Prime Minister said in July, the UK should be proud to lead the way in tackling antibiotic resistance, but we must ensure that the rest of world keeps pace. All Governments have a responsibility to tackle the problem and only with full co-operation across the world can we make a real impact.

We live in a globalised world, and 70% of the bacteria in it have developed resistance to antibiotics. We have been through a golden age of discovery and have sadly become complacent. We cannot become the generation that squanders that golden legacy. As the director of the Wellcome Trust, Jeremy Farrar, said:

“We are sleepwalking back into a time where something as simple as a grazed knee will start to claim lives.”

The golden age of medicine could well be behind us. It is time to step up to the plate as politicians and take decisions which might not bear fruit in the short term and might not secure votes in forthcoming elections, but can help to secure the golden age of medical discovery that we in this room have had the fortune to benefit from. We must ensure that it is not squandered for future generations.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 15th July 2014 Commons Chamber

[Julian Sturdy (York Outer) (Con)]

2. What steps his Department is taking to tackle the issue of antimicrobial resistance.

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

We are leading cross-Government action to address antimicrobial resistance—AMR—at national and global levels. We published details of how we will measure the success of the UK’s AMR strategy, and we will publish an annual progress report in November. We are considering recommendations in the Science and Technology Committee’s AMR report. I gave evidence to that Committee and we will publish our response in September.

[Julian Sturdy]

I very much welcome the Government’s international lead on antibiotic resistance, led by the Prime Minister. Does my hon. Friend agree that increasing the unit price of antibiotics and tackling their growing misuse in developing countries is absolutely vital if we are not to face a return to the medical dark ages?

[Jane Ellison]

My hon. Friend is quite right to highlight this as a major challenge facing us. I pay tribute to the chief medical officer and to the Prime Minister for the international leadership they have given on this. My hon. Friend will be pleased to hear that the antibiotics market will be considered in its totality by the O’Neill review, which was announced by the Prime Minister on 2 July. It is of course important to bear it in mind that while we look at tackling global antibiotic misuse, we need to balance the need for global conservation measures with accessibility for lower-income countries.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 25th February 2014 Commons Chamber

[Jane Ellison]

There is no complacency on the Government Benches, and attendances are half what they were under Labour. Week after week we have heard those on the Opposition Front Bench come to the House to talk up a crisis in our NHS, but the NHS has responded incredibly well throughout the winter. I pay huge tribute to the staff of the NHS for what they have done in responding to this. The Government are taking long-term action to reduce pressure on A and E; even the College of Emergency Medicine rebuts the Opposition line that there is a crisis in A and E this winter.

[Julian Sturdy (York Outer) (Con)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I would like to thank Public Health England and the NHS emergency services for their extraordinary work during the recent floods, and say that this House is proud of their dedication and commitment to help those in great need. Since the previous Health questions, we have also had the first anniversary of the Francis report on Mid Staffs. As a result, I am proud that the Government have taken significant steps to restore compassionate care to all parts of our NHS, with a regulator now free from political interference, failing hospitals being turned round, and more nurses, midwives and health visitors in our NHS than at any time since 1948.

[Julian Sturdy]

The family of my eight-year-old constituent Ben Foy have been fighting for more than two years for the funding of sodium oxybate—a drug that his doctors feel could help him cope with narcolepsy and cataplexy. This is a particularly distressing condition for Ben and his family, but sadly, after all this time there is still complete confusion as to who has responsibility for Ben’s commissioning request. Will the Secretary of State look into the matter and clear up that confusion?

[Mr Hunt]

I reassure my hon. Friend that I have looked into Ben Foy’s case, and NHS England has confirmed that it is responsible for commissioning his care. The particular drug that my hon. Friend mentioned is not recommended by the manufacturer for use by children and adolescents, but I am happy to arrange for him to meet NHS England and get to the bottom of the issue.

Hospices (Children and Young People)

Julian Sturdy Excerpts

Wednesday 18th December 2013 Westminster Hall

[Stuart Andrew]

That is a very valid point. Hospices do inspiring and innovative work.

[Julian Sturdy (York Outer) (Con)]

I congratulate my hon. Friend on securing this debate. He is making an incredibly powerful speech. We know how important fundraising is to the hospice movement. In my constituency, I have been working on and fundraising for Martin House’s “good night’s sleep” appeal, which is sponsored by BBC Radio York. It aims to provide the respite care that parents need—an issue that my hon. Friend touched on at the beginning of his speech. Will he join me in expressing his support for that appeal?

[Stuart Andrew]

Absolutely. I gave an interview to BBC Radio York this morning, and assured the people involved that we would get a mention of their fundraising efforts into this debate. My hon. Friend has managed to do that, and I am extremely grateful to him for ticking that box for me.

NHS Funding (York and North Yorkshire)

Julian Sturdy Excerpts

Tuesday 18th June 2013 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a privilege to serve under your chairmanship, Mr Streeter. I congratulate the hon. Member for York Central (Hugh Bayley) on securing what is an extremely important debate for York and north Yorkshire.

The hon. Member for York Central, other hon. Members from north Yorkshire and I have tirelessly campaigned for some time to secure a fairer funding formula for York and north Yorkshire, so I am extremely pleased to be able to speak today about a matter that is so important to me and my constituents. The hon. Member for York Central has clearly set out the history of the primary care trusts—now the clinical commissioning groups—and their current deficit. However, despite the deficit having being reduced over the past 12 months, York and north Yorkshire CCGs—as the hon. Member for York Central mentioned—are still starting off on the back foot compared with all other CCGs across the country, and that is sadly resulting in a postcode lottery system for health care for our area.

As we know from the hon. Member for York Central, the disparity within the allocation of the funding formula is due to its failing to take into account the rural nature of our county and, most importantly, age.

[Nigel Adams (Selby and Ainsty) (Con)]

I totally agree with my hon. Friend’s point about age. In north Yorkshire, we have one of the largest numbers of over-85s in the country, and the formula simply does not give enough weight to the ageing population. I would have though that it was as clear as the nose on your face that consideration must be given to the rural nature of a county and the degree of ageing of its population.

[Julian Sturdy]

I entirely agree with my hon. Friend. That is why in my short contribution this afternoon I will focus solely on age.

We must note that under the previous Government the funding formula was changed and more money put into the national health service. In addition, deprivation was given more weight in the formula. On paper, ensuring that deprivation is the most important factor, seems, morally, the right thing to do. However, I believe that when that reasoning is put into practice it starts to fall down. The distortion within the funding formula has resulted in some areas being awash with money, leading to well-publicised vanity health care projects, such as the one in Hull, with its 72-foot ocean-going yacht at the cool price of £500,000. At the same time, York and north Yorkshire have consistently struggled, as ably put across by the hon. Member for York Central, to balance the books, which has resulted in their continuing to take difficult decisions about health care provision.

An example of such decisions is that the primary care trust had to stop offering routine relief injections for sufferers of chronic back pain. That decision has had a massive impact on the quality of life of many of my constituents—it has hampered their ability to work and has affected carers. I have raised that issue previously in this Chamber, yet people are again coming through my surgeries, as I am sure they are through the surgeries of other hon. Members here today, suffering from a lack of access to those important injections. The decision is consequently putting more financial pressure on areas such as welfare, and that far outweighs the cost savings made by local authorities under the funding formula. That demonstrates the lack of joined-up thinking under the current system.

It costs approximately eight times more on average for the NHS to care for a patient who is over the age of 85 than one who is in their 40s. York and north Yorkshire, as my hon. Friend the Member for Selby and Ainsty (Nigel Adams) has set out, has one of the highest population of over-85s in the north, and my constituents are really suffering under the current formula. York and north Yorkshire also has a high number of care homes, and a typical GP practice states that 50% of home visits can be taken up just by care home residents, even though that group makes up only 2% of the patients on its roll.

I therefore urge the Minister, through NHS England, to review the current funding formula, to ensure that age is given more weighting.

[Julian Smith]

Was my hon. Friend not appalled, as I was, that when as a group of north Yorkshire MPs we sought clarification about why the NHS Commissioning Board had not given weight to the new Advisory Committee on Resource Allocation formula on age, we were told that the minutes of the meeting in which the decision was made could not be released, against the interests of all the people in our constituencies?

--- Later in debate ---

[Julian Sturdy]

I entirely agree with my hon. Friend. The important thing, as has been mentioned, is clarity. We have not had clarity, and we really do need it, considering all the work that hon. Members have put into the issue in our patch.

The change we are discussing would guarantee a much fairer funding formula across the country, and ensure that funding went to those in most need and those who have the highest call on our invaluable national health service.

Children’s Heart Surgery

Julian Sturdy Excerpts

Wednesday 12th June 2013 Commons Chamber

[Mr Hunt]

I thank my hon. Friend, and I am sure that that lesson will be learned.

[Julian Sturdy (York Outer) (Con)]

I very much welcome the Secretary of State’s statement, as will concerned families across my constituency of York Outer, and across the county of Yorkshire. Will he ensure that the new review recognises that units where paediatric and maternity services are located on a single site offer the optimal patient experience?

[Mr Hunt]

I think we need to be guided by the clinical evidence in that respect, but I urge my hon. Friend and his constituents, if they have a strong representation to make in that respect, to make it to the review when it re-proceeds.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

The right hon. Gentleman really cannot have it both ways. The budget for public health is also decided by an independent body, and we gave everyone a real-terms increase and then used any remaining money to even out the differences, to get everyone as close as possible to the independent formula. But if we are talking about spending, I think the right hon. Gentleman needs to say precisely whether he stands by his assertion that Governments should cut spending on the NHS by £600 million—[Interruption.] He says he has never said it before, but actually, up till now he has always said that it was irresponsible for the Government to increase spending in real terms. We have increased it; we have increased it by £600 million. He needs to come clean on whether he still wants to cut the NHS budget.

[Julian Sturdy (York Outer) (Con)]

Given that age is the main driver for an individual’s health care needs, why has not age been given more weighting in the funding formula in the past? I urge the Secretary of State to request NHS England to give as much weighting as possible to age in any future funding formula.

[Mr Hunt]

I recognise that my hon. Friend has campaigned on that issue a great deal, and I have great sympathy, because areas with high age profiles do have much greater needs for the NHS. That obviously must be weighted against things like social deprivation, which also have an impact. It is right for these things to be decided independently, which they are. The question is how we get closest to those independent allocations, and I know that that is preoccupying NHS England at the moment.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point, and he will be pleased to learn that the Government are more than doubling the amount of money that we put into dementia research. We need to catalyse the private sector companies because although they know that the size of their potential market of people with dementia is huge, they have been frustrated in their attempts to find the breakthrough medicine that we urgently need. We need to use the research to excite their interest and keep them focused on this truly tragic disease.

[Julian Sturdy (York Outer) (Con)]

8. What steps his Department plans to take to improve dementia diagnosis rates and to reduce regional variations in such diagnoses.

[The Secretary of State for Health (Mr Jeremy Hunt)]

There are unacceptable variations in the level of dementia diagnosis across the country, and we are committed to driving significant improvements. We have asked local areas, through the NHS mandate, to make measurable progress in improving dementia diagnosis over the next two years.

[Julian Sturdy]

In North Yorkshire and York, only 43% of those suffering from dementia receive a diagnosis. Given the ageing population in the county, that means that about 7,000 people with dementia remain undiagnosed. Does my right hon. Friend agree that the clinical commissioning groups have a large role to play in the delivery of dementia services, and will he tell us what support those groups will get?

[Mr Hunt]

My hon. Friend is absolutely right. It is a tragedy for those 7,000 people and their families that they are not getting a diagnosis. With a diagnosis, medicines and drugs could have a big impact and stave off the condition for between one in three and one in four people, and support services could also be put in place for carers. We need a massive transformation, and we need to make it much easier for people to get a diagnosis. We need much better understanding among GPs, as I mentioned earlier, and among hospitals as well, given that 25% of all in-patients have dementia.