Diabetes: Artificial Pancreas

Debate between Keith Vaz and Caroline Dinenage

Wednesday 12th December 2018 Commons Chamber

[The Minister for Care (Caroline Dinenage)]

I thank the right hon. Member for Knowsley (Mr Howarth) for his incredible work highlighting the importance of the right treatment for type 1 diabetes and of making use of technology in that treatment. I also thank him for giving us this opportunity to debate the issue. He has made some incredibly valuable suggestions, as indeed has the right hon. Member for Leicester East (Keith Vaz). I have listened with great interest and will carefully consider some of their fascinating suggestions.

Supporting the rising number of people with diabetes is one of the major clinical challenges of the 21st century, and improving outcomes and care quality for those living with, or at risk of, diabetes are key priorities for the Government. The right hon. Member for Knowsley correctly highlighted the role that modern technologies, when properly used, can play in the care of people with type 1 diabetes. Key to managing it is, of course, monitoring and controlling glucose levels, and—as he explained in great depth—a number of different technologies are available for that purpose, including glucose monitoring devices and insulin pumps.

As the right hon. Gentleman said, artificial pancreas devices are an emerging technology that combines continuous glucose monitoring with insulin pumps. One system, the Medtronic 670G system, which he mentioned, was recently approved by the US Food and Drug Administration and a European licence is being pursued.[Official Report, 23 January 2019, Vol. 653, c. 3MC.] Large randomised clinical studies of similar systems are now beginning and several are expected to come to the market in the next five years. Teams in the UK are leading some of that work.

The right hon. Member for Leicester East talked about the funding of research on diabetes. The Department funds such research through the National Institute for Health Research. In the last five years, the NIHR has awarded just over £144 million for work on diabetes, and 346 active projects are taking place across the NIHR infrastructure. One of them involves the closed-loop insulin delivery system to which he referred.

Giving people access to diabetes technology as swiftly as possible is, of course, a priority. Simon Stevens, chief executive of NHS England, said recently:

“Tens of thousands of people with Type 1 diabetes across the country will benefit from life changing glucose monitors on the NHS.”

The announcement referred to the FreeStyle Libre, a device that the right hon. Member for Leicester East also mentioned. NHS England will ensure that flash glucose monitoring is available on prescription to all patients who qualify for it in line with current recommendations. From April 2019, all qualifying patients will be able to receive it from their local GP or diabetes team.

The right hon. Member for Knowsley talked a lot about structured education and psychological support. In line with existing NICE guidelines, structured education should be offered to all patients within 12 months of diagnosis of diabetes. As he said, reported attendance levels at structured education courses have historically been low, but they continue to increase, and this year alone NHS England has invested £10.5 million to improve attendance by people with type 1 and type 2 diabetes.

[Keith Vaz]

May I pursue another point raised by my right hon. Friend the Member for Knowsley (Mr Howarth)? I understand that the NHS is still paying providers, even though people do not turn up. That is a big problem. We need to look at the providers. There is a reason why people do not turn up. We need to change the system in order to make them more able to do so.

[Caroline Dinenage]

That is an excellent point. The purpose of the £10.5 million that I have just mentioned is to improve attendance. It is clearly necessary to look at the way in which the service is provided and at who is providing it, and to ensure that it is provided in a way that will make people attend.

The right hon. Member for Knowsley spoke about improving care for those with diabetes and eating disorders, including what is often referred to as diabulimia. I think he will be pleased to hear that NHS England is supporting two pilots to test, trial and evaluate the effect of integrated diabetes and mental health pathways for the identification, assessment and treatment of diabulimia.

We will continue to create a health system that supports innovation, promotes the testing and development of health technology, and ensures that the best innovations are used so that patients can benefit as quickly as possible.

Question put and agreed to.