Antimicrobial Resistance

Debate between Karin Smyth and Gary Streeter

Tuesday 7th December 2021 Westminster Hall

[Karin Smyth (Bristol South) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Gary. I congratulate the hon. Member for Thirsk and Malton (Kevin Hollinrake) on bringing this very timely debate to Westminster Hall. It is timely because if we do not learn from the situation that we are in, we will end up in a very bad place; it is with that in mind that I give my remarks.

This is a really unusual subject; I have not been involved in a debate on it before, but it is one on which there is so much agreement. We have a problem, we have evidence of a problem, we agree that we have a problem, we have solutions that we generally agree on and we are genuinely world leaders. I think the Government sometimes bandy around the fact that we are world leaders when we are not; but we are genuinely world leaders in this area, and that is something to be proud of. We have some fantastic people in this country. However, why is the situation not improving? What more needs to be done, and, crucially, has enough been done in recent years? How do we know what has been done? As the hon. Member for York Outer (Julian Sturdy) said, why is there not greater interest and political pressure on this subject?

It was 2013 when Professor Dame Sally Davies described this as a

“catastrophic threat”.

She said:

“If we don’t act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can’t be treated by antibiotics. And routine operations like hip replacements or organ transplants could be deadly because of the risk of infection.”

It was in 2014 that the estimated figure of 10 million people dying as a result of AMR by 2050 was mooted. I was working in the health service when that discussion was being had, back in 2013-14. I vividly remember the concern of specialists, particularly colleagues in pharmaceuticals, about that, and the actions that were being taken to support clinical practice to make sure that did not happen. However, I do not think that most people walking the streets are aware of the catastrophic prediction made then.

We have a problem—we agree on the problem—and we know the causes of the problem: inappropriate use of antimicrobial drugs in healthcare; poor infection prevention and control practices; use of antimicrobial drugs in agriculture, and accelerated spreads of AMR infections through global trade and travel. Additionally, as the right hon. Member for Chipping Barnet (Theresa Villiers) and other hon. Members have said, there are limited numbers of new drugs available to replace those that become ineffective. The former Prime Minister, David Cameron, launched a review in 2014, and the list of 10 recommendations was published in 2016. In 2017, the cost of global action was estimated at $40 billion. That is an eyewatering sum, but when compared with what is being described as the incalculable cost of covid, which reaches trillions of dollars, that $40 billion estimate starts to look quite small. Others have indicated that in reality the cost of this could be unimaginable to most of us.

There was an excellent debate in Westminster Hall on 26 April 2016, in which my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) addressed the hon. Member for Mid Norfolk (George Freeman), who is also an expert in this area. My hon. Friend said:

“Although I welcome the renewed focus that today’s debate brings, I fear we are no closer to a solution than we were two and a half years ago.”—[Official Report, 26 April 2016; Vol. 608, c. 540WH.]

I think there is concern in the Chamber that that remains the case today.

The Government have targets, although they are not terribly specific. Many are for the period 2021 to 2025—for example, being able to

“report on the percentage of prescriptions supported by a diagnostic test…by 2024.”

On the eve of 2022, I expect the Minister to be able to outline how meeting those commitments is going. The hon. Member for Thirsk and Malton made some helpful suggestions for what we should be measuring, how we should be measuring it and how that should be reported, which I am sure the Minister will address.

On animal use, which the hon. Member for Strangford (Jim Shannon) highlighted, the investment required by farmers was yet to be formally evaluated in 2019, so it would be useful to know whether the Minister has evaluated that cost. It would also be helpful to have an understanding of how we are collaborating with our European neighbours, now that we have left the European Union, because we know that collaboration is really important, particularly in the agricultural industry.

We should be prepared, and we should certainly be on track, but I fear we are not, so the crucial issue is: what do we need to do? I pay tribute to Dame Sally Davies, our special envoy on AMR, and her work to highlight this issue, which, as she has said in the last year, is a silent pandemic. As she has told us, covid needs to be a wake-up call to the warnings that she has issued over the years. I have listened to her speak on this issue, as has another all-party group, and she has recently used quite a vivid image to describe the situation: covid is like putting a lobster into boiling water, but AMR is like a lobster in cold water. It is a silent pandemic.

One of the issues is that fewer adults know about this. I absolutely agree, and I think that is also true of Members of Parliament. We need to learn from covid, including about things such as altering behaviour, washing our hands and access to water. We also need to support those on the frontline much better, including through clinical direction, to help them in the way that they need in order to treat patients.

[Sir Gary Streeter (in the Chair)]

I call the Minister. Please remember to leave two or three minutes for Kevin Hollinrake to respond.