Antibiotics: Research and Development

Maggie Throup Excerpts

Tuesday 26th April 2016 Westminster Hall

[Julian Sturdy]

I agree with the hon. Lady’s last comments. She is right that antibiotics must be used as a last resort, which is why, as I will say, the current funding model for antibiotic research is broken, and why we have to correct it.

[Maggie Throup (Erewash) (Con)]

I take the point raised by the hon. Member for Newcastle upon Tyne Central (Chi Onwurah), with which my hon. Friend the Member for York Outer (Julian Sturdy) has just agreed. This is also about having the right diagnostic tests to ensure that people who need antibiotics receive them while ensuring that they are no longer handed out like sweets.

[Julian Sturdy]

My hon. Friend is right. Later in my speech, I will discuss the model of how antibiotics are used across the country. It is chilling how antibiotics are used in different parts of the country. Testing to find out resistance to certain antibiotics is also important before any antibiotics needed are used. It is not just a matter of how we bring new antibiotics to market, which can take 15 years; it is also about how we protect our existing armoury of antibiotics to buy us time for those new antibiotics to reach the market.

The £1 billion Ross fund was announced by the Chancellor in the spending review of November 2015. Some £350 million will be spent fighting AMR by strengthening surveillance of drug resistance and laboratory capacity in developing countries, and by delivering the new global AMR innovation fund with China. In January 2016, at the World Economic Forum in Davos, 85 major pharmaceutical and biotech companies agreed to the declaration on combating antibiotic resistance, which demonstrates the industry’s willingness to take up the challenge. Earlier this month, the Chancellor addressed the issue once again by highlighting the importance of AMR at the International Monetary Fund in Washington DC. He confirmed what the industry has long been telling us: that the reimbursement models for antibiotics are broken. I entirely agree that a global overhaul is required, and I will focus on that issue today.

Lord O’Neill has also backed proposals to change the way we develop new antibiotics for the marketplace. We all look forward to the AMR review publishing its final set of recommendations in the months ahead, and the Minister might be able to give us a firmer timescale for that review. In my previous debate on antibiotic resistance, I raised the key issues at stake in the growing challenge of this continuing problem. We know that using antibiotics inappropriately increases resistance and the risk associated with routine treatments. In the last debate on the subject, I mentioned that in India, many prescriptions are purchased over the counter to treat a wide variety of unsuitable illnesses, often with no professional diagnosis. Such practices compound the problem. However, it is greatly encouraging that many countries around the world have now woken up to the impending disaster that we could face if we simply do nothing.

As a consequence, things are starting to move forward, which must be seen as positive. However, the central challenge of getting new antibiotics on stream remains. As the Chancellor said earlier this month and as we have heard, the current funding model is no longer fit for purpose. The O’Neill report makes it clear that it typically takes about 15 years for an antibiotic to go from the initial research stage to final delivery to the marketplace. For that to happen, a large amount of money is required up front to fund the project, at a stage when the company has absolutely no idea whether the drug will succeed. Astonishingly, only about 2% of products, or one in 50 proposed new antibiotics, successfully make it to the marketplace. In the vast majority of cases, large sums of money are invested with no financial return whatever.

Although to a certain extent that is true of the manufacture of all new drugs, the problem is far worse for antibiotics. Conditions such as cancer or diabetes often closely follow demographic trends, so new drugs are also used as the medication of choice for cancer or diabetes, as they are more effective than the older prescriptions. In the case of antibiotics, however, generic products can treat infections as well as new drugs for far less money, except where there is resistance. Furthermore, in the attempt to slow the development of resistance, new antibiotics are often held back and are prescribed only when everything else has failed. That is the right thing to do. The market for new antibiotics is therefore limited to a small section of patients, as new drugs are used only when existing drugs are no longer effective. They will be required as a first-line treatment only many years after their introduction, by which time their exclusive patents have often expired.

That may explain why so many pharmaceutical companies have, sadly, exited the market over the years. Of the 20 pharmaceutical companies that were the main suppliers of new antibiotics back in the 1990s, only four remain. Furthermore, only five new classes of antibiotics have been discovered in the last 15 years. Sadly, some companies are waiting for resistance to rise before they even explore the viability of investing in a new product, which is clearly not in the best interest of patient health and wellbeing, or of the future of health care as we know it. Under the current funding model, the profitability of any new drug depends entirely on how many units are sold. As discussed, that is not suitable for the development of new antibiotics. Incentivising the increased use of antibiotics only increases resistance in patients, which can have devastating consequences.

The O’Neill review therefore proposes the creation of a more predictable marketplace that will sustain commercial investment in antibiotic research and development. A key proposal that has the full support of many pharmaceutical companies is for profitability to be de-linked from volume of sales for new antibiotics. That would guarantee developers an acceptable return on their investment when they produce a new antibiotic that fulfils an unmet clinical need. That is especially important when volume would not be sufficient to make the product commercially viable, despite its value to the NHS. A de-linked model also has the added benefit of eliminating any incentive to oversell antibiotics needlessly as cure-all miracle drugs, which, sadly, still occurs.

Before being elected as a Member of this House, as many know, I was a farmer—a farmer who produces food, not a pharma who is part of the prescription sector—so I do not pretend to know exactly what model is right for our national health service. However, it seems to me that an insurance-based approach that shares financial risk is certainly worth the Government’s consideration. Providing developers of the most important antibiotics with a fixed fee would remove the current financial uncertainty from the marketplace. It would also limit financial uncertainty for the NHS: if there were an outbreak of an infection requiring the antibiotic, the costs would be capped at an agreeable level.

I understand that AstraZeneca and the Association of the British Pharmaceutical Industry have been working closely with the Department of Health to develop such a model. We must continue to encourage innovation while doing what we can to remove the financial uncertainty of developing key new antibiotics. At the same time, it is essential that any new funding model provides the best possible value to the taxpayer. There should be no additional support in areas that are already adequately supported by the marketplace.

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[Maggie Throup (Erewash) (Con)]

It is a pleasure to serve under your chairmanship, Mr Evans. Like my hon. Friend the Member for York Outer (Julian Sturdy), I have also held a debate—an Adjournment debate—on the subject of AMR to look at the use of antibiotics in primary care. The UK, as we all know, is the envy of the world when it comes to research and development into new drugs and new drug technology. Antibiotics have been widely used to treat infections for more than 60 years. Without doubt they have saved many millions of lives, as my hon. Friend said. I doubt whether there is any hon. Member who has not taken antibiotics at some time in their life. It is extensive use that has created the problem that we have today.

Although new infectious diseases have been discovered nearly every year over the past 30 years, very few new antibiotics have been developed in that time. This means that the existing pool of antibiotics are used to treat more and more infections. My hon. Friend the Member for York Outer has eloquently outlined the problems in developing new antibiotics, but one of the consequences of their widespread availability and the relatively low cost of the current antibiotics is the extensive inappropriate prescribing of the drugs for conditions on which they will have no effect. That adds to the increasing resistance to these life-saving drugs.

In preparing for the debate today, I found out that treatment-resistant bacteria are responsible for approximately 25,000 deaths across Europe each year—similar to the number of deaths from road accidents. The “National Risk Register of Civil Emergencies” estimates that a widespread outbreak of a bacterial blood infection could affect 200,000 people in the UK, and if this could not be treated effectively with our existing drugs, approximately 40% of those affected could die: 80,000 people.

There is an urgent need for action to slow the spread of antimicrobial resistance. My hon. Friend the Member for York Outer referred to buying time to allow for the development of new antibiotics to catch up with need. I talked about the number of deaths due to road traffic accidents. We have seen widespread campaigns for road safety, and we need more campaigns to highlight the dangers of the overuse of antibiotics.

In the UK, 74% of antibiotics are prescribed in a primary care setting, and a staggering 97% of patients who ask for antibiotics are prescribed them whether they need them or not. Studies have shown that antibiotic resistance rates are strongly related to use in primary care. They have also shown that more than half of the antibiotics used in primary care are for respiratory tract infections, most of which are either viral in nature or self-limiting.

As this debate indicates, one method of tackling antimicrobial resistance is by incentivising research and the development of new antimicrobials. My hon. Friend made an excellent case for that. That obviously takes time and a huge amount of financial investment. We should also look at the role that diagnostics can play. Diagnostic tests can often be carried out rapidly, giving results in minutes. This allows immediate diagnosis and treatment choices. Such tests also prevent the need for over-prescribing and ensure that patients have the right drugs at the right time.

A couple of years ago, the chief medical officer described the threat of antimicrobial resistance as being

“just as important and deadly as climate change and international terrorism.”

On that basis, and taking all the evidence into consideration, it is vital that the Government do whatever they can to tackle this major threat. If I may be so bold, I will suggest to the Minister that in addition to measures such as incentivising research and development of new antimicrobials, the Government should consider improving access to diagnostic tests in primary care, and focusing research and development funding on diagnostics as well as on drug development.

Meningitis B Vaccine

Maggie Throup Excerpts

Monday 25th April 2016 Westminster Hall

[Maggie Throup (Erewash) (Con)]

Thank you for calling me to speak, Mr Pritchard, despite the fact that I was unable to be here at the start of the debate. It is a pleasure to serve under your chairmanship.

Decades of immunisation have provided protection from a wide range of diseases and have been crucial to improving the health of the nation—indeed, health worldwide. The United Kingdom benefits from a world-class immunisation programme, which, as other hon. Members have said, is envied by many other countries. Nevertheless, there is still variation in the take-up of some of the key vaccines in both the early and teenage years, and the take-up of the flu vaccine in the older and vulnerable population could be better, so there is a problem in every age group. That does not seem right, given that we are debating a petition calling for the men B immunisation cohort to be expanded.

I commend the UK for being the first country in the world to provide a men B vaccine. As we have heard, the Republic of Ireland is going to follow suit. We lead the way in many areas of medical research and healthcare, and I am delighted that we continue to do so for this important public health and disease prevention measure, which will tackle the devastating condition of meningitis B —and, indeed, all types of meningitis.

Having a wide-ranging immunisation programme can cause problems. During the pre-debate inquiry, we heard evidence from parents who knew that their child had been vaccinated against meningitis but did not know that there are numerous types of the disease and that one vaccine does not protect their child from all of them. That can cause parents to rule out the possibility that their child is suffering from meningitis, which can delay their seeking medical help.

[Seema Kennedy (South Ribble) (Con)]

Does my hon. Friend agree that the rapidity of meningitis B is terribly frightening for parents? I pay tribute to my constituent Emma Moore, who lost her first child, George, to meningitis in October 2013. She told me that she had a perfectly healthy little boy in the morning, and that by 11 pm at night she had to see his dead, lifeless body. She would not wish that nightmare upon anyone.

[Maggie Throup]

My hon. Friend is completely right that the speed of meningitis B is incredible. We heard various such stories in evidence. We must do everything we can to stop that.

The petition has already raised the profile of the disease, which will help to bust the myth that there is one meningitis and that vaccination against one strain makes a child immune to other strains. It is often difficult for parents to know what vaccines their children have had, when they had them, when their boosters are due, and what they are protected and not protected against. In evidence to the inquiry, we heard that irrespective of that confusion, medical professionals should and must trust parents’ instincts more. Despite the fact that the numerous vaccines for the different types of meningitis can be confusing, parents often have a sixth sense that tells them that something is really wrong. However, I understand that medical professionals are concerned that we are becoming more and more resistant to antibiotics, and that if a child is treated with antibiotics without clinical evidence, that resistance builds up even more. This is a complex subject with no easy answers.

The good news is that the vaccination programme has started and is almost one year in. This time next year, the majority of infants under two years old—the group that shows the greatest prevalence of meningitis B —will have been immunised. I am pleased that the Minister has asked the Joint Committee on Vaccination and Immunisation to reconsider the men B vaccination in the one to two-year-old age group. Given the potential community effect, I hope we will start to see the end of the disease.

There has been a lot of focus on meningitis B in recent months, but we must not lose sight of the impact of other types of meningitis or the fact that many other serious diseases can disproportionately affect infants, who cannot tell their parents or the doctor where they hurt or how poorly they feel. It was clear from the evidence that the Petitions Committee and the Health Committee took that a great deal of work still needs to be carried out to ensure that we get the best possible vaccines at the best possible price, and that they are as effective as possible. As is already happening, it is important to assess the outcomes of each and every infant who receives a men B vaccine. If possible, I would like to see data included from older children who have been immunised privately.

[Mrs Helen Grant]

In addition to vaccines, on which my hon. Friend is making a strong case, does she agree that we still need to do much more about prevention, and that the completion of the adolescent carriage study, which was recommended in June 2015, might be a good start? It would be helpful to hear from the Minister about progress on that.

[Maggie Throup]

My hon. Friend makes a good point, and I agree with her.

As we heard last week during the debate on funding for brain tumour research, no price can be put on anyone’s life, at any age. We must use all the evidence available and do whatever is necessary and appropriate to provide protection from meningitis and other potentially fatal conditions.

Junior Doctors Contracts

Maggie Throup Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

Without going over the previous points about the three years we have been around the negotiating table, I just say this to the hon. Gentleman: I think there are legitimate grievances for junior doctors, and they extend well beyond the contract. There are some big issues with the way training has changed over the years, and there are some serious issues we need to address about the quality of life for junior doctors—sometimes they have a partner working in a different city and they are unable to get training posts nearby to each other. We want to address those issues, which is why we set up a review, led by Professor Dame Sue Bailey, the president of the Academy of Medical Royal Colleges. Who is refusing to talk to that review, and refusing to co-operate with it? It is the BMA. That is why it is so important that people get around the table and start to talk about how we resolve these problems, rather than remaining in entrenched positions.

[Maggie Throup (Erewash) (Con)]

Can my right hon. Friend confirm that the new contract provides a far better work-life balance than the current contract, which doctors tell me cannot even help them to provide and plan for important family events?

[Mr Hunt]

Absolutely. One of the key changes in the new contract that we hope to see is much more predictability about weekend working, and a sense for junior doctors that when they do go into work at the weekends they will get the same support around them as they would during the week; it can be incredibly stressful when junior doctors are called into work at the moment. All these things are improvements, and what has made it very difficult is that these improvements have been misrepresented by the BMA to its own members, so that people have become very suspicious about these changes. That is why we tried so hard to get a negotiated outcome, and why we have been so disappointed that that has not been possible.

Brain Tumours

Maggie Throup Excerpts

Monday 18th April 2016 Westminster Hall

[Maggie Throup (Erewash) (Con)]

I congratulate the hon. Member for Warrington North (Helen Jones) on securing the debate, which, as we have seen, is important.

Like other hon. Members in the Chamber, I lost a good friend to brain cancer. She was aged just 41, and it is no consolation to Joy’s parents or husband, or indeed to her good friends, that she had 30 years more life than Danny Green, who was spoken of so passionately by my hon. Friend the Member for Castle Point (Rebecca Harris). Anyone who has read the book by Danny’s parents, Chris and Lisa Green, cannot fail to be moved by their story.

A cancer diagnosis of any type is not news that anyone wants to hear, but brain cancer affects those under 40 disproportionately, and funding must be increased. The arguments for extra funding have been rehearsed many times: symptom recognition, early diagnosis, more investment in research, targeted treatment—they all take funding. However, as we have heard, it is also partly the responsibility of the research institutes to make their bids for funding in this important area. One problem is that it is not recognised that funding is there. We need to change that, and today’s debate will help. I hope that raising the profile of the need for funding for research on brain tumours, through the petition and today’s debate, will trigger more funding requests.

I have mentioned before in debates, and I am sure this will not be the last time I do so, that we must break down the silos that exist not only in the NHS and social care, but in research departments. It is important to consider the long-term cost to individuals and to the health service and social care if we do not invest in research. I request that the Minister look at the health economics to see what we can do and how much more money we can invest, because that will save so much more long term. The long term is important with regard to individuals and the cost of supporting them, because the nature of the treatment and the site of the cancer mean that many are left with lifelong disabilities and need a tremendous amount of support. Some of that support is offered by our amazing hospice movement, such as Treetops in my constituency, which provides incredible hospice care.

As my right hon. Friend the Prime Minister outlined last week, spending on cancer research has gone up, but today the question is how that is distributed. I ask the Minister to do whatever he can to ensure that brain cancer gets its fair share of that increased spending and that it moves up the agenda, so that there is more investment in the research and development of new drugs and new ways of treating these people, who are predominantly young people with their lives ahead of them.

Dementia and Alzheimer’s Disease

Maggie Throup Excerpts

Tuesday 12th April 2016 Westminster Hall

[Jim Shannon]

I was going to come to that issue. I thank the hon. Gentleman for that intervention. It is not just about the diagnosis of dementia and Alzheimer’s, but about the follow-up, the path of care and how we help the whole way through. I will touch on some of those things later in my speech.

We must not abandon or diminish our efforts to find a cure. We have to take into account the reality we face and carefully plan for the future, so that all those with dementia and Alzheimer’s can get the care and support they so desperately need. As the hon. Gentleman said, that is the issue we have to address.

[Maggie Throup (Erewash) (Con)]

We are talking about end-of-life support, but we have to take a practical approach. One of the charities in my constituency—Community Concern Erewash—has a project to dementia-proof houses in Erewash to help people in the early stages of dementia stay in their houses for longer. They are doing things such as labelling drawers and rooms, so that people know exactly know where they are and can navigate their house for longer. Does the hon. Gentleman agree that such practical measures will make a difference?

[Jim Shannon]

The hon. Lady is absolutely right. The simplest things can make a difference. It is about improving quality of life and letting people with dementia and Alzheimer’s have a life with their families.

--- Later in debate ---

[Jim Shannon]

The hon. Gentleman has clearly hit on a very salient point.

In relation to the science and medical sectors, I ask the Minister about the significant spend on and moneys set aside for the investigation into how dementia happens, which the hon. Member for Beckenham (Bob Stewart) asked about in his intervention. That money will help to find a cure—and we need to find a cure, because we have to give hope. To give hope, we have to have medical interventions and the investigations leading to them.

[Maggie Throup]

The hon. Gentleman is talking about a cure. Recently, I visited the department of human genetics at the University of Nottingham, which is working hard on a genomics project to identify the change in the genes that might cause dementia and Alzheimer’s, so there is light at the end of the tunnel, although it is a long way off. Great work is being carried out, however, not only in Nottingham, but in many places in the UK and throughout the world.

[Jim Shannon]

We have to encourage all medical advances.

The number of people living with the condition in the UK is revealed as more startling when we take into account the unsung heroes—the carers.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 22nd March 2016 Commons Chamber

[Mr Speaker]

May I gently point out to colleagues that, very useful and comprehensive though these exchanges have been, as usual at this stage we have got a lot to get through and we need to speed up a bit? There is a long waiting list of colleagues and we must get through that list.

[Maggie Throup (Erewash) (Con)]

6. What progress the 100,000 Genomes Project has made on providing UK leadership for international developments in precision medicine.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Our groundbreaking 100,000 Genomes Project, which was announced by my right hon. Friend the Prime Minister as part of our 10-year life sciences strategy, represents the moonshot of medicine in making the UK the first nation on earth to sequence the entire genetic sequence of 100,000 genomes from NHS patients. Through our precision medicine strategy, the launch of 13 genomics medicine centres in the NHS, funding from Government and the precision medicine catapult, we are winning international plaudits and attracting inward investment, as a sign of our commitment to a 21st century NHS.

[Maggie Throup]

I recently visited the medical school in Nottingham where I saw the great work being carried out, including groundbreaking genomics work on identifying Alzheimer’s risk genes. What support is the Department providing to ensure that work is fully funded and expanded, so that the east midlands and the UK continue to be world leaders in the search for treatments and ultimately a cure for Alzheimer’s, based on our research?

[George Freeman]

I pay tribute to my hon. Friend, who had a distinguished career in the life science sector, including through setting up her own business. She is right to highlight the work at Nottingham University which, along with Leicester and Birmingham, represents something of an east midlands powerhouse. The Nottingham University Hospitals NHS Trust is part of the East of England NHS Genomic Medicine Centre, recruiting patients and becoming one of our hubs for NHS genomics medicine. In addition, we are actively supporting research into Alzheimer’s through our £1 billion a year National Institute for Health Research budget, the £150 million Dementia Research Institute and our dementia plan. I continue to lead conversations with dementia charities.

End of Life Care

Maggie Throup Excerpts

Wednesday 2nd March 2016 Commons Chamber

[Maggie Throup (Erewash) (Con)]

I am pleased to be able to speak in this very important debate. It is pleasing that, as we have heard from so many other hon. Members, end-of-life care in the UK is ranked No. 1. That is not good enough, however, because there are so many variations across the whole of the UK. I am sure the reason why we are ranked No. 1 is mainly due to the wonderful hospice movement that we have heard so much about. It contributes so much to so many thousands of lives every day across the whole country. It is the medical professionals, the volunteers, the fundraisers and the donors who really make the difference. As I said, the system is not perfect and we still have an awfully long way to go. There are too many times when end-of-life care is a lottery, and that should not be the case.

My constituency has actually done quite well out of that lottery. We have an amazing hospice called Treetops Hospice Care. It is quite unusual because it does not have any beds. It provides all its care either as day care or in patients’ homes. As a consequence, the number of people who are able to die in their own homes in my constituency is much higher than in other parts of the country. In the past, Treetops has benefited from two lots of capital funding: in 2010 it managed to get capital funding to extend its day care centre; and in 2013 it got capital funding to build a counselling and bereavement centre, which has been so valuable to those who have suffered the loss of their loved ones. One of my messages for the Minister, therefore, is please do not forget about capital funding. It is so important to hospices across the whole country.

The chief executive of Treetops asked me to say that money invested in hospices often saves the NHS money because hospices can deliver end of life care so much more effectively. The NHS is not for the end of life; it is for acute episodes, not best designed for the time when people need to be in quite a different environment.

As other hon. Members have mentioned, we need to realise that hospices are not only for people with cancer; they are for people with life-limiting conditions. There still seems to be a bit of fear about this: if people are told that they need palliative care and end-of-life care and they do not have cancer, they get confused. We need to make sure that our messaging is a lot clearer.

My hon. Friend the Member for Totnes (Dr Wollaston) talked about gaps in the service. My local CCG acknowledged gaps in the services it was commissioning. It was lucky enough to get funding from Macmillan to look at how to pull together the end-of-life care it was able to commission. It realised that the issue is not always about commissioning hospital beds or drugs; it can be about something really simple.

People coming towards the end of their lives need extra laundry, and for the people who are caring for them, having to do all the laundry is, sadly, about the last straw when it comes to the caring commitments they make. Our CCG identified that a local charity, Community Concern Erewash, has a laundry service. The CCG is able to contract out to a local charity to provide the laundry service for those going through end-of-life care. This means that many more people will be able to stay in their own homes because those caring for them can provide the emotional care without being distracted by the need to provide laundry. That provides one practical example of how it is possible to invest money wisely to make end-of-life care so much better.

All too often, our focus is on end of life care for adults, but we must never forget the importance of providing choice and support for children and young people at the end of their lives and of the subsequent bereavement counselling for their families. I would like to take this opportunity to pay tribute to the work done by the organisation, Together for Short Lives, in providing such counselling. The more we discuss subjects such as end-of-life care in this place, the more open people become about talking about such a difficult subject; they feel more able to discuss it. We never used to discuss cancer, but now we do, so it will be possible for us to talk about end-of-life care in a much more open way. As individuals, as parents, as children and as spouses, we should be brave enough to talk about end of life.

Our healthcare professionals should also be brave enough to talk about the issues. I know from personal experience that when a Macmillan palliative care nurse had that conversation with my mum, it made the last few months of her life so much easier. It made it easier for us, too, as we no longer needed to tread carefully on the subject. Mum could openly talk about her wishes—what she wanted done with certain bits of jewellery, for example, and other things she wanted to communicate to us. When she did pass away six months after that initial conversation with the end-of-life care nurse, we knew her wishes and what to do, which made it easier for us.

Talking about end-of-life care and knowing the wishes of the patient makes it so much easier for the healthcare professionals and the relatives—and, most importantly, for the patients. We must do whatever is possible to make sure that the final wishes of those with terminal illnesses are met, so we can ensure that they can have good deaths.

Junior Doctors’ Contract Negotiations

Maggie Throup Excerpts

Monday 8th February 2016 Commons Chamber

[Ben Gummer]

I entirely agree with the hon. Lady about the passion and dedication of junior doctors—and never once has the Secretary of State or I questioned that. What we have questioned are the tactics of the BMA’s leadership. I happen to agree with her, too, about her previous employer Unison. I have constructive relationships with that union. I disagree with it, and it with me—often—but we agree on many things and have a straightforward relationship. I am afraid that it is difficult to do business with the BMA, however, when it promises to talk about one thing and then refuses to do so a few weeks later, when it refuses to come to the negotiating table for months, and when it misleads its members in a way that I do not think Unison has ever done.

[Maggie Throup (Erewash) (Con)]

The residents in my constituency tell me two things: first, how much they value the work of doctors, both junior doctors and consultants; and, secondly, how disappointed they are that this House is not united in saying that the strike is not justified on safety grounds. Is the Minister as disappointed as my residents?

[Ben Gummer]

Yes, and I would add the 2,800 people who have had their operations cancelled. I wonder what answer they would get from the Opposition about whether they support or condemn those cancellations. As soon as we get an answer to that very simple question, it will be easier for us to know the official position of Her Majesty’s Opposition.

NHS (Charitable Trusts Etc) Bill

Maggie Throup Excerpts

Friday 22nd January 2016 Commons Chamber

[Michael Tomlinson]

Again, I do not have those figures to hand. My hon. Friend is right to raise this because it is an issue of concern; cost must always be borne in mind, but, as I have said, I am speaking to the principle, and unfortunately I do not have the specific figures she asks for.

[Maggie Throup (Erewash) (Con)]

Cost is important, but the transparency angle outweighs it.

[Michael Tomlinson]

My hon. Friend, who has put her name to these amendments, makes a valid point, and helps me to make the argument that the public consultation is the right way forward.

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[Mr Rees-Mogg]

I agree with my hon. Friend. I want to finish on this set of amendments by saying that this House should be jealous of its role as the major focus of consultation in the nation. We were elected to represent our constituents and therefore to express views on these issues. That is why we are here, and what is done with consultation so often is a pretence. It is not about the Government wanting the wisdom of the millions before making up their mind but about the Government wanting the comfort of having been through a rigmarole to get what they wanted in the first place. We should not give up our authority lightly or increase the power of the Executive.

I know want to turn briefly to the amendments tabled by my hon. Friend the Member for North West Hampshire, which are absolutely glorious in their conception. They basically reverse what the Bill is trying to do in the first place, which is a great thing for him to have slipped past our ever-attentive Clerks. That does not often happen on Report. Perhaps the amendments—and this is why our Clerks in their wisdom let them go through—would ensure that there is a safeguard. Safeguards may be sensible. There have been occasions where charities have got into trouble when public money is being spent. Although it is broadly considered a good idea to remove the power from the Secretary of State to appoint trustees so that a decision is made more locally and so that the construction of the charities may be more suitable for the local organisations—that has a great deal of support —we know that something will go wrong at some point.

That is not a particularly Cassandra-like view to take; it is just the experience that we have. We know that there will be a small charitable hospital that puts all its money into an Icelandic bank, for example, and suddenly loses it. The trustees get criticised and attacked, or they write 3,000 letters a year to elderly ladies asking them for money and are seen to have behaved badly. Then somebody will come forward, probably a Member of this House, who will ask the Secretary of State at Question Time, “Why is it that you, Secretary of State, are not doing anything to stop this problem arising? Why have you not kept those residual powers? Why did you not ensure that when the Bill went through Parliament, there was a safeguard, something to protect—”

[Maggie Throup]

I agree with my hon. Friend’s argument. That could happen to any charity, not just an NHS charity, so why introduce safeguards specifically for NHS charities?

[Mr Rees-Mogg]

My hon. Friend makes an interesting and important point. NHS charities are different because of the structure of the national health service and the conception of the national health service in people’s minds. There is much less of an immediate governmental interest, or concern with, ordinary private charities that were founded sometimes centuries ago with grants from generous benefactors that through the mists of time have evolved and developed. NHS charities work side by side with the state in all that they do, so they are a marginal extension of the state rather than something completely different from it. If we draw a Venn diagram of the third sector, we have a part that is very private and another part that is very much state. NHS charities are very much in the state part of the Venn diagram.

--- Later in debate ---

[Kit Malthouse]

Fifteen years on the Public Accounts Committee—extraordinary! I therefore take his words seriously. He is right that the key is to get the governance entirely right.

I guess the point that I am making—maybe I am a lone voice, although perhaps I am joined by my hon. Friend the Member for North East Somerset—is that even with the most ideal governance in the world, things occasionally go wrong. In that instance, the Secretary of State must have the power to step in, given the critical nature of the services these charities perform and their inextricable link to the national health service.

[Maggie Throup]

My hon. Friend’s amendments would undermine the whole purpose of the Bill, which is to give these charities their independence. As he rightly says, the Charities (Protection and Social Investment) Bill, which is going through the House at the moment, will strengthen the protections and the governance arrangements for charities such as these.

[Kit Malthouse]

I acknowledge that point, but we have been round this carousel a couple of times. I pose just one question to those who are nervous about my amendments: in the event of something going wrong, who would fire and replace the trustees? No one. They become a self-governing group. One of the problems with charitable governance is that there are no shareholders to dispose of underperforming trustees. Charities have to acknowledge their own bad performance and fire themselves. In a situation where there is an inextricable link to a particular establishment, the Secretary of State needs to have the ability to step in, in extremis.

It is often forgotten that charities receive public money, and no charity is more likely to receive public money than an NHS hospital charity. Such charities are more likely to receive grants for their performance of services, projects, equipment and so on. We therefore have a particular interest in NHS charities.

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[Wendy Morton]

My hon. Friend raises an interesting point. The key point of my private Member’s Bill is to enable this group of charities to achieve what they said they wanted in the consultation, which is a shift away from the Secretary of State’s powers to appoint so that they can demonstrate independence. The charity world has moved on so much since charities were first created, and the model of governance needs to change in the same way.

What makes this particularly interesting is that previous rules surrounding the appointment of individual trustees were restricted to one linked person only. In any case, I believe that the new arrangements in the Bill—not the amendments—are far better and far more beneficial because this “blend of trustees” helps further to help and enhance communications and understanding by both the charity and the trust. Surely that can only be a good thing.

If I may, as the Member in charge of the Bill, I would like to touch on amendment 9, which deals with the use of the NHS logo and was tabled by my hon. Friend the Member for North East Somerset (Mr Rees-Mogg). I shall not make too many references to fashion. Although I could make many a link between logos—and, indeed, brands—and fashion, I shall leave Members to draw their own conclusions about the fashion, style or otherwise of my hon. Friend. To be fair, he raised the issue of the NHS logo on Second Reading, so it is only right for him to bring it forward today as an amendment for consideration. I bow, if not to his fashion sense, to the grace and eloquence of his style in speaking to his amendment today. Perhaps we could share some lessons.

The term “logo” can be defined as a symbol or other small design adopted by an organisation to identify its products, uniforms, vehicles or perhaps a company or organisation. It is often uniquely designed for ready recognition, and I think the NHS logo fits that definition. It is instantly recognisable, and the public know exactly what it is all about. However, I cannot support the amendment because I believe it is a matter best explored through the Department of Health or perhaps through the memorandum of understanding, which is part of the move to independent charity status. It should not become part of this Bill.

At risk of sounding—hopefully not appearing—more like Hook than Wendy Darling, I will bring my comments to a conclusion by simply saying that although we have explored worthwhile amendments this morning and raised some important points, I shall not support any of those amendments.

[Maggie Throup]

I am delighted to speak in support of this important Bill on Report and congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on leading it through the complexities of the House. In the time available—I shall keep my contribution short because I realise how long it has taken us to get this far this morning—I shall speak specifically against amendment 2. If accepted, it would give the Secretary of State the power to introduce secondary legislation to re-establish his or her right to appoint trustees to NHS charities.

Charitable giving is one of the cornerstones of our society, with the Charities Aid Foundation estimating that in 2014 alone £10.6 billion was donated by the British public to a variety of good causes. Indeed, we are the home of some of the world’s greatest charitable fundraisers such as Children in Need, Comic Relief, Sport Relief, and not forgetting, of course, Live Aid.

One clear message that came out of the 2014 consultation on the governance of NHS charities was that potential donors felt put off by the perceived lack of independence of the charities from the Government. One of the Bill’s fundamental principles that seeks to rectify this perception —one that I wholeheartedly support—is the removal of the right of the Secretary of State to appoint trustees to particular NHS bodies or to appoint special trustees.

The Bill is designed to give more autonomy to NHS charities to appoint their own trustees and bring them into line with most of the rest of the charitable sector, in which that is already common practice. As well as removing the perception that the charities lack independence from Governments, such a move would enable them to adopt different legal forms specific to their needs, particularly those offering limited liability. It would remove the barriers of dual regulation under both NHS and charity legislation, which currently make it difficult for NHS charities to achieve and demonstrate true independence.

[Seema Kennedy]

My hon. Friend is making a very good point. Members may have seen a report in today’s Times about trusted professions. Apparently doctors are trusted by 89% of the population, but Ministers—not politicians as a whole—are trusted by only 22%, although I am sure that that does not apply to my hon. Friend the Under-Secretary of State. Surely vesting independence in these charities independently and drawing them away from Governments will only enhance their local reputation.

[Maggie Throup]

I entirely agree. That is exactly why I feel that they need to be independent from Secretaries of State and Governments. I must read the whole of that article: it sounds extremely interesting. We must think about how we can improve our image in the public domain.

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[Jane Ellison]

How nice it is to hear about that charity. I congratulate my hon. Friend on taking the opportunity to praise it and to shine a spotlight on a charity that so richly deserves it. Indeed, well done to him for name-checking Paddington in a debate that has been otherwise dominated by Peter Pan. We will see whether any more well-loved characters make an appearance before the end of the debate.

[Maggie Throup]

I cannot lay claim to any characters in my constituency. It is not just the work that charities do in hospitals that is important, but the work that they do outside hospitals to make sure that people do not go into hospital. One of my local charities, Community Concern Erewash, recently linked up with the Alzheimer’s Society to work in the community to help people suffering from Alzheimer’s to cope in their own homes and stay in their homes a lot longer. Will my hon. Friend praise that charity and recognise the contribution that such charities make to our society?

[Jane Ellison]

I am delighted to add my praise for my hon. Friend’s charity. I was honoured after the election to have dementia policy added to my portfolio as public health Minister. She is right to draw our attention to the need to work outside hospital to keep people safer in their own homes. As I know from working with dementia charities, large and small, much of that work is done by small local charities. I am delighted to echo her praise for the charity in her constituency.

To return to the amendments, although the largest charities require a level of professional management, the same is not required by many of the smallest ones. The corporate trustees arrangement, whereby the board of the trust or, prior to that, the board of the hospital acts as the trustee, is not sufficient to manage the large sums that are held by the largest NHS charities. They need a more professional approach, in many cases. The Government first took steps to address that issue in 1973. The Secretary of State took powers to appoint so-called special trustees to manage charitable property on behalf of hospital boards. Three hospitals—Moorfields, the Royal National Orthopaedic hospital and Great Ormond Street—appointed such special trustees to manage their charitable funds.

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[Wendy Morton]

I beg to move, That the Bill be now read the Third time.

Let me begin by thanking Members who are here today for giving up another constituency Friday to take part in the debate. Some of them were also present on Second Reading, including my hon. Friends the Members for Erewash (Maggie Throup) and for North East Somerset (Mr Rees-Mogg), who is no longer in the Chamber. I also thank those who served on the Public Bill Committee, absenting themselves from the debate on Syria to be present on that day, and, again, I thank Members on both sides of the House who sponsored my Bill last summer after my name had been drawn in the ballot, allowing Peter Pan to find his Wendy—or, at least, I hope so. I thank the Department of Health for its help, and, as a new Member, I thank those in the Public Bill Office, whose patience has been admirable. I should also record my thanks to the hon. and learned Member for Holborn and St Pancras (Keir Starmer) for supporting the Bill; sadly, he is not present today.

I welcome my new Tinker Bell to the Dispatch Box. I feel duty bound to reassure her that I remain on my guard for ticking crocodiles, Captain Hook and, of course, those unruly Lost Boys, although they are not here at the moment.

I am, of course, delighted that my NHS (Charitable Trusts Etc) Bill—commonly known, I hope and believe, as the Peter Pan and Wendy Bill, without brackets or Etc—has safely arrived at its Third Reading. There has been no exit stage left, or right, taking it directly to Neverland; it is still en route to another place, and, I trust, to Royal Assent.

On Second Reading, we were given many examples—some based on personal experience—of the importance of NHS charities and their role in supporting hospitals, patients, parents and staff. That has been underlined by the accounts that we heard today of the tremendous work that NHS charities do, and it also demonstrates the Bill’s importance in helping those charities to continue and flourish.

As I have mentioned before, NHS charities are regulated under charity law, but they are also linked to NHS bodies and bound by NHS legislation. They are charitable trusts, established under NHS legislation, and have as their trustee an NHS body such as a foundation trust, or trustees appointed by the Secretary of State for an NHS body. It should be borne in mind that NHS charities are distinct from independent charities established solely under charity law.

Funds donated to the NHS must be held separately from Exchequer funding provided by the taxpayer. These charities exist to support their beneficiaries, and there is a special relationship between them and the trusts with which they are associated. Some wonderful examples have been given today of local hospital charities and the special relationship that they have with their local NHS trusts.

The first part of the Bill makes provision to remove the Secretary of State for Health’s powers to appoint trustees for NHS charities in England and makes amendments to primary legislation concerned with this. It is important to remember that this fulfils a commitment by the Government in 2014, subsequent to a DOH review and consultation on the governance of NHS charities. The outcome of the consultation was that NHS charities would be allowed to convert to independence if they chose to do so and the Secretary of State for Health’s powers to appoint trustees to NHS charities under the National Health Service Act 2006 would be removed at the earliest opportunity.

It is fair to say that a number of the larger NHS charities called for reform because of concerns that the NHS legislative framework limited their freedom to grow and develop their charitable activity to best support their beneficiaries and to demonstrate to potential donors a visible independence from Government. That is an important point, and some have already grasped the opportunity to become independent while others are in the process and some are planning to do so in the future.

Collectively across the country about 260 charities currently exist to receive and manage charitable funds on behalf of NHS charities. I am sure Members will be interested to know that just over £345 million was raised by these charities in the last financial year, supporting patients and staff right across the country, so we should be doing all we can to support them. They make an outstanding contribution, yet their work often goes unheralded. I hope that today’s debate helps to publicise their work and the valuable contribution they make to hospitals as well as to the lives of patients, their families and clinicians. But just as healthcare moves on, so does the charitable environment, and there is a real need to place certainty in an already complex structure. I hope, and believe, that that is what this Bill will do.

There are currently 16 NHS charities that have trustees appointed by the Secretary of State for Health, and all of them are affected by my Bill. They are bound by charity law and NHS legislation. They are unincorporated and their trustees have unlimited liability.

[Maggie Throup]

My hon. Friend mentions that NHS charities are bound by charity law as well as other legislation. We both sat on the Charities (Social Investment and Protection) Public Bill Committee. Can she expand on why her Bill should be a separate Bill and why its measures cannot go through as part of that Bill?

[Wendy Morton]

My hon. Friend makes an interesting point. I also sat on the charities Bill Committee, and it comes back to the House next week, I believe. My Bill is a specific piece of legislation. It came about because of Great Ormond Street hospital and the need to move the right to the royalties. It also comes under the remit of the DOH, whereas the charities Bill is under the remit of the Minister for Civil Society and the Cabinet Office. My Bill, at its heart, goes to the fact that the original Act on the Peter Pan royalties and the extension to the signed copyright patent was unique—so that unique bit of legislation needed another unique bit of legislation.

Sixteen of the charitable trusts have chosen either to revert to a corporate trustee model or to become independent. Most hospital charities operate the corporate trustee model anyway, and we have heard a lot about that today. Many have indicated that they are seeking to make this transition and many others are also considering it.

Six charities have already completed the transition to independence. These include Barts Charity, which raises money for Barts Health NHS Trust, including St Bartholomew’s hospital. This was the first to receive an independence order. The others are Alder Hey in Liverpool, Birmingham Children’s Hospital Charity, which is close to my own constituency of Aldridge-Brownhills, Guy’s and St Thomas’ Charity, and the Royal Brompton and Harefield Hospitals Charity. They are all now able to benefit from greater independence and less bureaucracy, and that further demonstrates the benefits of the Bill. Great Ormond Street’s is one of the six to have converted to independence. I will come back to that, as well as to its unique status and the need for specific legislative change to remove the statutory obstacle currently preventing the charity from becoming fully independent. Of the remaining NHS charities, about half have agreed to convert to independence but have not yet formally informed the Department of Health, while the others are in discussion with their trustees and hospital boards.

Importantly, the Bill is supported by Great Ormond Street hospital and NHS charities more generally. It also has the support of the Association of NHS Charities, and I would like to put on the record my thanks to it for its help. Let me provide a quote from a chief executive of an NHS charity, as that is a good way of explaining why the Bill is important. This chief executive said that

“this is exactly the right move for us as it deals with a peculiar anomaly in our status. Moving to full independence will mean that we can compete on a level playing field with other health and social care charities in our fund raising and other activities. No longer being seen as part of government.”

On Report, we received some interesting amendments from hon. Members, who gave us the opportunity to explore and question a number of points in relation to the Bill. Although I am pleased they were not pressed to a vote and were not accepted, I believe each was worthy of our sincere consideration.

Turning now to the second part of the Bill, it is important to remind ourselves of the special link that Great Ormond Street hospital has with J. M. Barrie, who made a very generous bequest to it of the right of royalties to the “Peter Pan” stories. As I explained on Second Reading, J. M. Barrie bequeathed all rights to “Peter Pan” to GOSH in 1929. He died in 1937, with GOSH enjoying a further 50 years of royalties. On the eve of the copyright expiring, the J. M. Barrie bequest acquired its unique legal status as a direct result of Lord Callaghan’s amendments to the Copyright, Designs and Patents Act 1988. That reserved royalty income to the hospital trust and carried the stipulation of the creation of a special trust at that time. Though now held in perpetuity by GOSH, legislation is needed to enable the receipt of royalties to move to the new, independent Great Ormond Street Hospital Children’s Charity. My Bill, with its provision for amendments to the 1988 Act, will do that. It will enable GOSH to take full advantage of this move to independent status, thereby giving it greater freedom to attract additional funding. It will also reduce the burden of bureaucracy by leaving it under the sole jurisdiction of the Charity Commission.

I am sure Members will be interested to know that I have met representatives from the GOSH Children’s Charity, and, as I reported on Second Reading, I have visited the hospital to see for myself the work the charity does and the huge contribution it makes. I have also met members of staff and clinicians to hear about some of the cutting-edge research and treatments they are working on. My visit to GOSH further emphasised the importance of this Bill. One cannot go there and fail to be touched by the work that goes on there, the commitment, the dedication and the inspiration—it is truly amazing, as indeed is the work of all our NHS hospitals and charities.

As we all know, the work and influence of Great Ormond Street children’s hospital stretches way beyond Greater London, which is why so many Members are in the Chamber to support and watch the progress of this Bill. In the financial year 2014-15, the GOSH charity raised a staggering £80,981,000, an increase on the previous year’s figure.

In November, I am sure that avid newspaper readers will have noticed that The Independent and the Evening Standard launched their Gift to GOSH Christmas appeal, attracting celebrity backing as well as a pledge from my right hon. Friend the Chancellor of the Exchequer to match donations pound for pound from the Treasury with up to £1.5 million. I am fortunate enough to have an update from Great Ormond Street hospital, which tells me that to date £2.7 million has been raised as a result of that appeal. That reflects the warmth felt by the British public towards Great Ormond Street, as well as their generosity. The campaign still has not ended—it runs until 14 February—so who knows what the final total will be. Those funds are going to support things such as paediatric research and a new specialist unit for children with heart failure.

One of the most generous donors over the years has been, of course, J. M. Barrie, whose bequest of the royalties from “Peter Pan” is one of the reasons we are here today. It is amazing that even today, 79 years after the death of Barrie, the bequest is still a crucial source of income to the charity, which demonstrates that “Peter Pan” remains a firm favourite of us all. I must confess that I watched it over Christmas and, as one might expect, the book has had a permanent place on my desk for number of months. It is probably in my handbag in the Chamber today.

By supporting the Bill today, I believe that we are all doing a little bit to help the work of Great Ormond Street Hospital Children’s Charity by securing the J. M. Barrie income stream for the new independent charity. Without this Bill, it would be unable fully to complete its conversion to independent charity status. Without it, I believe that there could be risks to legacies to the charity, and I would not wish to see that happen. It also creates further complications, because operating two charities side-by-side requires a duplication of governance, separate accounts and, potentially, duplicate returns to the Charity Commission. The Bill is not just needed, it is wanted, and Great Ormond Street Hospital Children’s Charity has confirmed this. It is also supported by the chair of the hospital trust, Baroness Blackstone, who I must also thank for her support, and the charity’s chair of trustees.

To summarise my Bill, it has received support from Members on both sides of the Chamber, for which I am grateful, from Great Ormond Street Hospital Children’s Charity and from the Association of NHS Charities. It delivers on commitments that followed a Department of Health review and consultation on the governance of NHS charities, whereby charities were given the opportunity to seek greater independence under the sole regulation of the Charity Commission and the Secretary of State’s powers to appoint trustees were no longer necessary. It paves the way for sensible housekeeping.

We listened to some interesting amendments today that enabled further scrutiny of the Bill, for which I am grateful. I hope that this Bill, which I have believed in from the outset, does not end up in Neverland but heads out of this Chamber across Central Lobby to land safely on the Red Benches of the other place to continue its passage. I commend the Bill to the House.

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[Maggie Throup]

I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on getting this very important Bill to its Third Reading, and I am delighted to support it in this debate. It is great to see a private Member’s Bill get to this stage with the support of everybody in the House.

As I have said in this place before, our nation would be a poorer place without the thousands of charities and trustees who contribute their time and expertise without fear or favour. Close to my heart are the many hospital-related charities that play such an important role in supporting our free-at-the-point-of-care national health service, which has served us so well. It is vital that those charities are allowed to conduct their amazing work with as few barriers as possible.

I am often asked by people in this place and elsewhere, “Where exactly is Erewash?” My reply is that it is in Derbyshire, between Derby and Nottingham; for that reason, many of my constituents end up going to Nottingham hospitals for their care, as well as to Royal Derby hospital and our local Ilkeston community hospital. I know that my constituents will be pleased that I am supporting this Bill, as it will have an impact on the nearby Nottingham Hospitals Charity, which raises money to improve facilities and fund new equipment. It provides important additional services, supports staff development, and initiates local medical research at Queen’s medical centre and Nottingham children’s hospital, as well as at City hospital, Ropewalk House, and Hayward House. On its website, the charity outlines that

“thanks to the generosity…of its donors and fundraisers, it is able to fund the ‘added extras’ to make the experience of being in hospital better for people of all ages.”

It truly is at the heart of care for patients.

Examples of how the charity’s money has been spent include £15,000 for a heart function monitor for sick children, which helped to save the life of a six-month-old baby within hours of its being installed; £1.1 million for better ward facilities for children with cancer; £150,000 to kick-start medical research projects with the aim of improving treatment and services for a whole host of conditions and diseases; and £2.1 million towards a new centre to transform the care of cystic fibrosis patients. The charity currently has two main ongoing appeals: first, raising funds for an on-site helipad at Queen’s medical centre, which is the east midlands’ trauma centre; and secondly, raising money for a beautiful and serene courtyard garden for those suffering with ear, nose and throat cancer.

No doubt the general public would think that Nottingham Hospitals Charity, like the majority of charities, is free to appoint its own trustees, but under current legislation this is likely not to be the case. Yet nearby in Ilkeston, at our community hospital, there is a very active league of friends that does have complete freedom to appoint its own trustees. We have heard today about the good work of leagues of friends across the whole country, and Ilkeston community hospital’s is no exception. It raises money with the same aims as Nottingham Hospitals Charity—to fund the added extras to make the experience of being in hospital better for people of all ages. It is also at the heart of care for in-patients and out-patients at Ilkeston community hospital.

The league of friends is a dedicated group of people who, in addition to making cups of tea for patients and visitors, hold a wide array of fundraising events. For a busy person anywhere near Ilkeston next December, I recommend that they visit the Christmas fair, as I am sure there will be a stall there, as there was last December, selling really nice Christmas cakes. As I had not had time to make my Christmas cake, one of those cakes saved my life; the people who came to my house were able to sample its delights. Recent fundraising has resulted in the charity buying a scanner for the Valerie Jackson scanner suite at the hospital, to name just one successful project that the group has supported.

So why do we need this Bill? As I see it, there are three main disadvantages to the current structure of NHS charitable trust status. First, potential donors may perceive that the charities lack independence from Government, and that may put them off donating. Secondly, being bound by legislation prevents the charities from adopting different legal forms specific to their needs, particularly those offering limited liability. Thirdly, the Charities Commission believes that dual regulation under both NHS and charity legislation makes it difficult for NHS charities to achieve and demonstrate independence. It is therefore vital that NHS charities have the opportunity to move to independent charity status. My constituents in Erewash, like so many others across the UK, are extremely generous in their support for charities. It is important that every barrier, whether perceived or real, is removed, to allow maximum generosity and altruism.

I want to touch on Great Ormond Street Hospital Children’s Charity. As my hon. Friend the Member for Aldridge-Brownhills has said, despite the hospital’s location in London, and owing to the specialist nature of its work, it provides a truly national resource for children with some of the most severe and complex illnesses imaginable. I am sure that at least one child in at least one family in every constituency has benefited from the healthcare provided by Great Ormond Street hospital. Like every hospital, whether generalist or specialist, it has fantastic doctors and nurses, and a whole host of healthcare professionals who together make our NHS the envy of the world. I am sure that the whole House will agree that we owe them a great debt of gratitude for the work they do.

A number of years ago, I had the privilege of seeing at first hand, in a professional capacity, the work of Great Ormond Street hospital. We often see news of the groundbreaking work it does. There was a good news story recently about the innovative work carried out on gene editing, which means that a one-year-old girl is now in remission from blood cancer. That is fantastic news for the girl and her family, and it also gives hope to other families in similar situations. I am sure that, without J. M. Barrie’s generous and powerful donation of the rights of “Peter Pan” to Great Ormond Street, such work would not be possible.

The first time this Bill came before this House, I was rightly corrected by my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) when I suggested that J. M. Barrie would have been cheering from the Gallery if he had been able to hear that his wishes are to be continued as a result of this Bill. My hon. Friend pointed out that the good author would have been ruled out of order for cheering from the Gallery, but I am sure he would have been cheering very quietly if he had been here today.

The Bill provides for some much-needed changes to legislation, and it will benefit NHS charities generally and Great Ormond Street hospital specifically. I commend it to the House.

Infected Blood

Maggie Throup Excerpts

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

I thank the shadow Minister for responding in those terms. It is much appreciated. As he says, we all want to try to move forward with a consensus in support of the people affected by this tragedy. I will try to respond to his questions, although I might have to write to him on one of them because my on-the-spot maths is not quite good enough.

On funding, as I have made clear several times before, the money will come from the Department of Health budget, and we have identified an additional £100 million over this spending review period, which allows us to double the current spend on the existing schemes. This is in addition to the £25 million announced in March 2015. Spend to date is £390 million and the projected future spend is £570 million, so together with the £100 million and the £25 million, that amounts to more than £1 billion over the lifetime of the scheme. I hope that provides the hon. Gentleman with some clarity on funding.

The hon. Gentleman asked about lump sums. It can be seen in the consultation documents that we are consulting on options for both those already bereaved and those who will be bereaved in the future, and we are asking people how they feel about continuing with a discretionary approach or taking a one-off payment that would be based on a multiple of the discretionary payment they get in the current financial year—or indeed a hybrid of the two. We are trying to be as open as possible, so people can give us their views on how they see the way forward.

I have seen the Scottish proposals and I had a conversation with my opposite number in Scotland this morning before I came to the House. Because one of the options for bereaved people is an ongoing payment, albeit a discretionary one, I would not compare it with what I understand the reference group in Scotland has put forward as a pension. Obviously, we are talking about access to ongoing but discretionary payments. Again, I look forward to hearing the views expressed during the consultation on that issue.

It might be helpful for Members to know that 160,000 people in England have hepatitis C. Those affected by this tragedy make up fewer than 2% of the hepatitis C population in England. The NHS has to treat people on the basis of clinical need. The treatments are in the region of £40,000 each—quite expensive treatments. However, we believe more treatments are in the pipeline, which is one reason why I am so keen to ensure that clinical expertise is embedded within the new scheme. We are particularly keen to understand, in respect of the people who do not quite reach the current NICE guidelines for rolling out treatment in the NHS, whether, by recognising the unique circumstances of the people affected by this tragedy, we can do something within the scheme to support them. We need to understand how many people will be interested. Members might find it helpful to know that while not every genome type of hepatitis C is susceptible to the new treatment, the majority, thankfully, are. For some people, none of the new treatments is clinically appropriate.

I think I have dealt with the key questions that the hon. Gentleman asked me. I would be happy to carry on working in the spirit in which he responded to my statement and come back to him with any further clarity that he seeks subsequent to this debate.

[Maggie Throup (Erewash) (Con)]

I thank the Minister for her statement and for the measures she has outlined today, as well as for her continuing commitment to seek justice for the victims of contaminated blood, including some in my constituency. When it comes to looking at drugs for the future, will the Minister commit to continuing investment in molecular diagnostics as the way forward for victims in the future?

[Jane Ellison]

The Government and the NHS have made it very clear that we greatly welcome what we see as a rapidly changing landscape. There is huge commitment on this issue. I am joined on the Government Front Bench by the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), who is doing a great deal to accelerate some of the newest treatments and their adoption within the NHS. I can absolutely give that commitment that we always want to stay at the cutting edge of medicine. One reason for delaying this consultation, perhaps to the frustration of some, is that we now have a fuller picture of the current state of the available treatments. The last three treatments that are to be rolled out in the NHS were not approved by NICE until 25 November. I want to ensure that we are always up to date with the treatment landscape as it evolves, as we hope it will continue to do.