Antibiotic Resistance

Lord Young of Cookham Excerpts

Wednesday 15th October 2014 Westminster Hall

[Sir George Young (North West Hampshire) (Con)]

It is a pleasure to follow the hon. Member for Inverclyde (Mr McKenzie), who set out clearly the problems of antibiotic resistance. I compliment my hon. Friend the Member for York Outer (Julian Sturdy) on his choice of subject and on how he developed the argument and presented the case, ending with a three-point action plan, which I hope that the Minister will be able to smile on when she responds to the debate.

Over the recess, I read Dame Sally Davies’s book, “The Drugs Don’t Work”, which was published last year. It is concise and understandable by a layman, but deeply alarming, particularly as it comes from the country’s chief medical officer. She warned that antibiotic resistance should be treated as seriously as terrorism when we rank threats against this country. The hon. Gentleman and my hon. Friend set out the problems as the risks of antibiotic resistance become greater because of over-prescription and overuse. At the moment we are all preoccupied with Ebola, which is a virus and not a bacterium, but many lower-profile cases of new strains of antibiotic-resistant bacteria are being introduced into NHS hospitals as a result of the admission of patients who have recently arrived from overseas.

As my hon. Friend the Member for York Outer said, if we do not raise our game against the superbugs, the chief medical officer warns that a cut finger could lead to a festering death. Each year across Europe, some 25,000 people die from drug-resistant-bacterial infections. As he said, the new antibiotic-resistant threat is from the less well known, so-called gram-negative bacteria, which have names such as Klebsiella, Pseudomonas and Acinetobacter. In many parts of the world, those bacteria are either untreatable or only treatable by a toxic antibiotic called colistin, which was discovered in the 1940s. Its use carries huge risks, as my hon. Friend said, because of its toxicity. The new strains of gram-negative bacteria create severe clinical problems for patients in intensive care units or other critical care units, such as oncology or transplant. The highly antibiotic-resistant bacteria affect very sick patients, who are found in intensive care and other high-risk units. Some of those bacteria lead to death rates of 50%.

Again as my hon. Friend said, no new gram-negative antibiotics are at an advanced stage in the drug discovery pipeline, so the historical approach of relying on the pharmaceutical industry to come up with a solution will not come to our rescue this time. He explained why we have a classic case of market failure. The business case against developing antibiotics is powerful. It can take 10 years and cost more than £1 billion to bring a new drug to market and, because those bacteria evolve fast and rapidly become resistant to new antibiotics, the research needs to be ongoing. Even if a successful drug is developed, a course of antibiotics might only last a week, so the revenue potential of any new drug is relatively low. My hon. Friend contrasted that with investment in statins, for example, which a patient may take for the rest of his or her life without developing resistance, so in a sense the question of where to put the money is a no-brainer. As a result, AstraZeneca is scaling back research into antibiotics and Roche has issued warnings about the terms of trade.

There is some good news. The severity and acuity of the problem is beginning to be recognised. WHO published a document highlighting the problem in April, and President Obama signed the Generating Antibiotics Incentives Now legislation. As both the previous speakers said, we await Jim O’Neill’s report next spring on why the industry has failed to deliver any new antibiotics. It is not clear, however, how the market failure can be addressed without Government intervention of some sort —my hon. Friend the Member for York Outer outlined a number of possible solutions. It would be helpful if the Minister could confirm that she has an open mind about changing the terms of trade with the pharmaceutical industry, if that proves to be the only way forward.

I am interested in the subject because I have in my constituency a firm called Bioquell, which manufactures equipment and provides specialist services that eradicate micro-organisms—bacteria, viruses and fungi. Its new Pod product comprises single-patient rooms that can be rapidly deployed in hospitals. Crudely put, they can turn a “Nightingale” ward into US-style single rooms. The single-patient room Pod product is generating interest from hospitals around the world worried about Ebola.

As became clear in one of our exchanges on Monday following the statement by the Secretary of State for Health, hospital structures throughout the world vary. Most intensive care units in France and the USA comprise single-patient rooms, whereas most ICUs in the UK comprise open, multi-bed units, which are often linked to high infection rates. We therefore need to have tools available to combat the threat from antibiotic-resistant organisms, which differ from country to country.

At the moment, Bioquell is involved in the decontamination of health care facilities around the world that have housed Ebola patients. Those include three hospitals in the United States, as well as hospitals in the UK, France and Holland. Recently, 20 of the company’s single-patient room Pods have been deployed in the middle east to help a hospital combat the spread of viruses. A small technology company from Andover—this ties in with my hon. Friend’s third point—is therefore leading specialist decontamination work in Europe and the US, helping to combat Ebola through the provision of safe single rooms.

I ask the Minister for an assurance that the contribution companies such as Bioquell can make will not be overlooked. The NHS is sometimes slow to adopt new technology, but when it faces substantial capacity and cost pressures due to an ageing population, the adoption of new technology must form a key part of the solution to those ever-growing pressures.

We rightly celebrate our knowledge-based economy. My hon. Friend the Minister’s Department has done much to export life sciences, to encourage med-tech industries and to generate export earnings. In return, however, the Government must support British innovation in the NHS. It is unrealistic to expect companies to be successful at exporting if they do not have a robust domestic market.

I end with the point my hon. Friend made about public interest. I hope the debate he has initiated will begin to drive the issue up the agenda, and bring home to the public and, I suspect, many of our colleagues the real threat antibiotic-resistant bacteria pose to the NHS. I do not think our colleagues appreciate that, with these new strains of bacteria, the NHS faces a major challenge, with high associated death rates, and no effective antibiotics exist. Unchecked, these bacteria will limit the ability of the NHS to provide many of the life-saving procedures we all take for granted, and the costs to the NHS will increase substantially. That means there must be a positive response to Jim O’Neill and active engagement with companies at the cutting edge of research in this field so that we can begin the fight back against these antibiotic-resistant bacteria.

[Several hon. Members]

rose—