Health Service Medical Supplies (Costs) Bill

Natascha Engel Excerpts

Ping Pong: House of Commons
Wednesday 15th March 2017 Commons Chamber

Consideration of Lords amendments

[Madam Deputy Speaker (Natascha Engel)]

I must draw the House’s attention to the fact that financial privilege is engaged by Lords amendments 1, 2, 18, 19 and 21. If the House agrees them, I will cause an appropriate entry to be made in the Journal.

Before Clause 1

Duty to have regard to the life sciences sector and access to new medicines and treatments

[The Minister of State, Department of Health (Mr Philip Dunne)]

I beg to move, That this House disagrees with Lords amendment 3.

[Madam Deputy Speaker]

With this it will be convenient to discuss Lords amendments 1, 2 and 4 to 24.

[Mr Dunne]

I remind the House of the importance of this Bill. NHS spending on medicines is second only to staffing costs. The NHS in England spent more than £15 billion on medicines during 2015-16, a rise of nearly 20% since 2010-11. With advances in science and our ageing population, the costs will only continue to grow.

The UK has a lot to be proud of: we have a world-class science base and an excellent reputation for the quality and rigour of our clinical trials and the data they produce. The UK has one of the strongest life sciences industries in the world, generating turnover of more than £60 billion each year. Indeed, it is our most productive industry. The Government are deeply committed to supporting it to flourish and, in doing so, to provide jobs and transform the health of the nation.

In the 2016 autumn statement, an additional £4 billion of investment in research and development was announced, specifically targeted at industry-academia collaboration. We expect the life sciences industry to be a substantial beneficiary. That comes on top of measures such as the patent box and the R and D tax credits that the Government have introduced to encourage investment from innovative businesses.

That determined action is reaping rewards. The UK ranks top among the major European economies for foreign direct investment projects in life sciences. Last month, the Danish drugs company Novo Nordisk announced a new £115 million investment in a science research centre in Oxford. That comes on top of an additional investment of £275 million announced by GSK last June and AstraZeneca reaffirming its commitment to a £390 million investment to establish headquarters and a research centre in Cambridge—it is good to see the hon. Member for Cambridge (Daniel Zeichner) in his place. Looking ahead, Professor Sir John Bell, the regius professor of medicine at Oxford, has agreed to lead the development of a new life sciences strategy for the long-term success of UK.

At the same time, it is important that we secure better value for money for the NHS from its growing spend on medicines and other medical supplies. I remind the House that, overall, the Bill will do three things. First, it will enable us broadly to align our statutory scheme for the control of prices of branded medicines with our voluntary scheme, by introducing the possibility of a payment percentage for the statutory scheme. That could deliver £90 million of savings annually for the NHS. Secondly, the Bill will give us stronger powers to set the prices of unbranded generic medicines if companies charge unwarranted prices in the absence of competition.

Thirdly, the Bill will give us stronger powers to require companies in the supply chain for medicines, medical supplies and other related products to provide us with information. We will use that information to operate our pricing schemes, to reimburse community pharmacies for the products they dispense and to assure ourselves that the supply chain of specific products provides value for money for the NHS and the taxpayer.

During the Bill’s passage through the other place, the Government tabled 23 amendments, following debate and discussion in this House and with peers. I firmly believe that those amendments make it a better Bill. However, I will start with Lords amendment 3 and set out the reasons why it does not improve the Bill.

Lords amendment 3 would introduce a duty on the Government, in exercising their functions to control costs, to have “full regard” to the need to

“promote and support a growing life sciences sector”

and the need to ensure that patients have access to new medicines. The amendment would undermine one of the core purposes of the Bill by hindering the ability of the Government to put effective cost controls in place. Controlling the prices of medicines cannot, in itself, promote the interests of the life sciences sector and deliver growth. Having such a requirement in legislation could encourage companies to bring legal challenges where the cost controls have not, in themselves, promoted growth in the life sciences industry. That could significantly hinder the Government’s ability to exercise their powers to control costs effectively.

For example, if the Government were to take action to control the price of an unbranded generic medicine, because it was clear that the company was exploiting the NHS—several examples of that have been raised throughout the Bill’s passage through this House—it could be argued that that action did not promote the life sciences sector, because every generic drugs manufacturer could argue that it is a life sciences company. Nevertheless, that would, of course, be the right thing to do for the NHS, for patients and for taxpayers. Lords amendment 3 would enable companies to challenge any action by the Government to control costs by arguing that proper regard had not been paid to supporting a growing life sciences industry. The amendment would therefore make it more difficult to control costs, including where companies seek to exploit the NHS over and above the interests of patients, clinicians and taxpayers.

I say gently to those on the Labour Benches that it is ironic that they talk tough on the pharma companies, which they claim in other forums routinely seek to exploit the NHS, when today they are arguing the cause of the industry by supporting an amendment that would provide it with a legal stick with which to challenge the NHS when it seeks to control the costs of drugs, some of which, as they acknowledge, are exorbitantly priced. I therefore have to ask the hon. Member for Ellesmere Port and Neston (Justin Madders): whose side is Labour on?

The Government are seriously concerned that Lords amendment 3 has the potential to impact negatively on our ability to control costs. I do not expect that that was the aim of well-intentioned Members in the other place. I hope both Houses agree that it would be damaging to the NHS if, on every occasion that the Government deem it necessary to use their powers to control costs, the Government could be challenged for failing to give full regard to promoting the interests of life sciences companies.

The second part of Lords amendment 3 requires the Secretary of State to have full regard to the need for NHS patients to benefit from swift access to innovative medicines that have been recommended by the National Institute for Health and Care Excellence through its technology appraisals. However, NHS commissioners are already legally required to fund drugs and other treatments recommended in NICE technology appraisal guidance, normally within three months of final guidance. The Secretary of State’s power to control costs is a completely separate process. Therefore, this part of the amendment would not achieve anything.

NHS and Social Care Funding

Natascha Engel Excerpts

Wednesday 11th January 2017 Commons Chamber

[Madam Deputy Speaker (Natascha Engel)]

I advise the House that Mr Speaker has selected amendment (a) in the name of the Prime Minister.

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[Margaret Greenwood (Wirral West) (Lab)]

I can see Wales from my constituency, to continue the theme. I received an email this morning from a very distressed senior NHS manager, who says:

“I truly despair that there will not be an NHS this time next year”—[Interruption.]

You need to listen on the Government Benches, and understand what your Secretary of State is doing to the health service. I will give a precis of what my constituent is talking about.

[Madam Deputy Speaker (Natascha Engel)]

Order. The hon. Lady will resume her seat. First, when she says “you”, she is addressing the Chair. Secondly, she is making an intervention. There are 33 Members who wish to speak in this very important debate. If she can keep her intervention very brief, I will let her continue.

[Margaret Greenwood]

Apologies, Madam Deputy Speaker. I should not have used the word “you.”

My constituent has written to me saying:

“The NHS is in crisis, the government knows this, CCGs have failed, foundation trusts are failing. GPs are on their knees. So they’re”—

the Government—

“handing it back to local areas and saying, ‘you fix it, and by the way there’s no money.’ It’s a whole system reorganisation”,

and there is no money.

Health Service Medical Supplies (Costs) Bill

Natascha Engel Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Tuesday 6th December 2016 Commons Chamber

[Rob Marris]

I propose, Madam Deputy Speaker, not to take the remaining three hours. Earlier, when the Minister would not take an intervention, he seemed to think there was a rush on time. My reading of the Order Paper is that we have another three hours for the Bill, but I will not take that long.

I want to put the Bill in context, because this is a socialist Bill. It builds on the Labour Government’s National Health Service Act 2006, which applied to England. Looking around, Madam Deputy Speaker, I think you and I may be the only Members present who voted for the 2006 Act—that was obviously before you were in your esteemed position. In putting the current Bill in context, it is worth reviewing what it is building on.

The 2006 Act made reference to the voluntary schemes for price control that existed then. The current voluntary scheme, of course, is the 2014 pharmaceutical price regulation scheme—the PPRS. Those voluntary schemes were to do with limiting the profits of pharmaceutical companies. Now, I stress to the House that the Labour party and I are not opposed to pharmaceutical companies per se; they do fantastic research, and there are probably millions of people alive now who would not otherwise have been alive, because of the research and development done by pharmaceutical companies—many of them, happily, based, or having major operations, in the United Kingdom. The companies are very welcome here, but they have to play by the rules, and so do those that buy up off-patent drugs, horse around with them and put up their prices by hundreds and hundreds of per cent. Sometimes, it is a minority of private equity companies that are doing that, and they are not welcome here.

Pharmaceutical companies must act responsibly, and they may need statutory encouragement to do so. The 2006 Act started the process of statutory encouragement with a statutory scheme, which enabled Her Majesty’s Government, in appropriate cases, to limit prices and the profits of pharmaceutical companies—that is why I say this is a socialist scheme. Before those on the Government Benches get all aerated about this, let me say that the Labour party and I do not wish to nationalise or control the prices in every corner store in the country—not at all—but there are certain big operations where market intervention is helpful and is needed when there is market failure. It was perceived—rightly—by the Labour Government that there was some market failure, and they needed some stern measures to sort it out.

The Bill builds on that work from 10 years ago because, as adverted to by the Labour Front-Bench spokesperson, my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders), some medicine supply companies—again, a minority—were, frankly, taking the mickey. They were leaving the voluntary scheme in favour of the statutory scheme because that was more advantageous to them. I understand why they would do that—they wished to maximise their profits—but they must act in a responsible way, and if they will not do so as a result of being urged to show corporate social responsibility, which some of them will not, we need statutory measures, and that is what the Bill puts in place. One of the things the Bill does is to address the issue of companies leaving the voluntary scheme to go into the statutory scheme because it is a better deal. The Bill resets the schemes, as it were, to make sure that a company is not encouraged to do that, because there is not that comparative advantage.

The Bill also makes provision for a new power to enable the Secretary of State for Health to require a company in the voluntary scheme to pay sums due under that scheme. Even though it is a voluntary scheme, the Bill will give the Secretary of State the power to pursue non-payers through the courts. I regard that as progressive legislation. For those companies that are not acting responsibly—that are taking the mickey, as I characterised it—that is a good thing. This Government have come down the socialist path to agree with such market intervention.

The Government have also come down the Labour party path in wanting to marshal information so that we can treat these companies equally and fairly, and so that they treat the society in which they operate—refracted principally through their supply of medicines to the NHS—equitably and fairly. Under the Bill, the Secretary of State will have the power to make regulations for the marshalling of information, building on the work done in the NHS Act 10 years ago.

That is important, but on the context of the Bill, I would like to tempt Health Ministers a little further down the socialist path. The Minister described it in his opening remarks as a technical Bill, which it broadly is. However, it also has an ideological or philosophical aspect, which I have tried to set it out, because it is broadly a socialist Bill. One of the things it seeks to do is to save money for the NHS and to raise money for the NHS through clawbacks on overpriced medicines or medical supplies because the NHS—this is the context of the Bill, which is not purely technical—is in serious financial difficulty. The Minister referred to the extra £10 billion of funding for the NHS over the lifetime of this Parliament, but even the Health Committee does not accept that calculation. It is a sleight of hand.

Part of that sleight of hand relates to what is being done on social care, which is leading to a growing problem of delayed discharges. Social care is not being properly funded in this country, and the precept that councils in England are allowed to charge is in effect a mandatory charge because the Government calculate the revenue support grant and all such local government things on the assumption that councils will raise the precept. That is having an effect on the NHS because of delayed discharges.

In the context of the crisis in social care, although the extra funding it will provide for the NHS is welcome, the Bill comes nowhere near addressing the underfunding of the NHS. In the financial terms of what it will raise or save for the NHS, the Bill—in relation to what the NHS needs and, coupled to that, what councils in England need for social care—is a drop in the ocean. The Bill will encourage a certain level of efficiency in the production, purchase and procurement of medicines and medical supplies. All of us in the House would sign up to the concept of efficient procurement. We might sometimes have different definitions of what does and does not constitute efficient procurement, but procurement is central to the Bill.

Although the NHS can, like any massive organisation, almost always act more efficiently—I hope the Bill will encourage the NHS to do so—we must bear it in mind that, in international comparisons, the NHS is one of the most efficient organisations in healthcare delivery in the world. If we look at healthcare delivery in the United States of America, for example, we can see that it spends, as a proportion of GDP, as much on public health as the United Kingdom. However, because its public health system is not run efficiently, as it is all fragmented, the USA spends the same proportion of GDP again on private health—

[Madam Deputy Speaker (Natascha Engel)]

Order. May I remind the hon. Gentleman that the Bill is quite specific and that this is a Third Reading debate? He is venturing into areas that are not specifically in the Bill, and he may wish to come back to what is in the Bill.

[Rob Marris]

I am grateful to you for your guidance, Madam Deputy Speaker. As I have said, I am putting the Bill in the context of the NHS and its effect in addressing the much deeper problems of the NHS. I was simply adverting to some of those deeper problems, but I take your guidance.

I repeat to Ministers that the Government have come some way, as the Bill demonstrates, down a socialist path for the delivery of healthcare, and I encourage them to come back with another Bill, building on this one, to abandon privatisations and let us have a public NHS.

Question put and agreed to.

Bill accordingly read the Third time and passed.

Contaminated Blood and Blood Products

Natascha Engel Excerpts

Thursday 24th November 2016 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. I am going to impose a 10-minute limit to start with, and then we will see how we get on.

National Health Service Funding

Natascha Engel Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Jonathan Ashworth]

I give way to my hon. Friend. [Interruption.]

[Madam Deputy Speaker (Natascha Engel)]

Order. That is enough shouting.

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[Dr Allin-Khan]

I thank the right hon. Gentleman for allowing me to speak again. I shall refer at length to St George’s hospital in my speech, but it is very unfair of him to bring it into this debate. It is because of this Government that St George’s hospital is operating at a £50 million deficit. It is because of this Government that we are now in special measures. It is—

[Madam Deputy Speaker (Natascha Engel)]

Order. The hon. Lady is hoping to catch the eye of the Chair later in the debate. As it is, there will be a five or four-minute time limit, so Members who intervene must do so very briefly and not very frequently. If they do not do so, I am afraid that they may not be called to speak.

[Mr Hunt]

The shadow Health Secretary also did not talk about cancer. In 2010, we had the lowest cancer survival rates in western Europe. Since then, we have referred for cancer tests 2,200 more people every day, and 100 more people are starting cancer treatment every day. The cancer charities say that this is saving 12,000 lives a year. On mental health, he did not mention the fact that we are treating 1,400 more people every day, with record dementia diagnosis rates.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Before I call the SNP spokesperson, I must inform hon. Members that, including her speech, we have calculated, generously, that every speaker will have five minutes, but we will probably have to go down to four minutes at some point.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Does that include five minutes for me also?

[Madam Deputy Speaker]

Obviously the hon. Lady has no speech limit, but the speech limit has been calculated with her mind. I am just saying that the longer someone speaks for, the less time everyone else will have.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Following that public service announcement, I must reduce the time limit for Back-Bench speeches to four minutes.

--- Later in debate ---

[Margaret Greenwood (Wirral West) (Lab)]

The funding crisis in the NHS is no accident. It is a political choice made by the Tories for which patients and NHS staff are paying the price in longer waiting times, delayed operations, and increasingly stressful working conditions. It is a crisis driven by the Government’s demand that the NHS make £22 billion-worth of efficiency savings—or cuts. This is impossible without huge damage to our national health service.

An analysis by The Guardian of 24 of the 44 STPs stated:

“Thousands of hospital beds are set to disappear, pregnant women will face long trips to give birth and a string of A&E units will be downgraded or even closed altogether as part of controversial NHS plans to reorganise healthcare in England…Dozens of England’s 163 acute hospitals look likely to have services, including cancer, trauma and stroke care, removed as a result of the plans”.

In the 2015-16 financial year, the NHS reported a record net deficit of £2.45 billion—nearly three times higher than in 2014—and so we see the crisis in services accelerating. Last week, the chief executive of NHS Providers, Dr Chris Hopson, said:

“The NHS simply cannot do all that it is currently doing and is being asked to do in future on these funding levels.”

STPs are supposed to facilitate the integration of health and social care, for which they require the support of council leaders, yet the leader of Wirral Council has said in the past 24 hours that he has not been given the opportunity to feed into the development of the local plan. The STP for Cheshire and Merseyside is of great concern to my constituents because it requires nearly £1 billion to be taken out of local health services. If this goes ahead, the impact on the NHS will be devastating; it is impossible that it would be otherwise.

There was recently a proposal to close Arrowe Park hospital, Clatterbridge hospital and Countess of Chester hospital and build a new hospital in Ellesmere Port, and there has been no denial that such a conversation has taken place. The annual report of the foundation trust that runs Arrowe Park and Clatterbridge says:

“The Trust will explore with Countess of Chester Hospital the potential for the development of a single acute general hospital covering Wirral and west Cheshire within the next 10-15 years …Another option is to move all planned surgery and procedures to Clatterbridge, while Arrowe Park will become a ‘hot site’ dealing mainly with emergencies.”

It is not clear what a “hot site” is if it is not a hospital. Surely the point about an A&E is that it needs to be in a place where there is a very wide range of expertise on how to deal with any emergency. I have very real concerns about the future of Arrowe Park hospital, which is a major hospital highly valued by my constituents who use its services and who work there; indeed, it is a major employer in my constituency. The STP talks of “hospital reconfiguration”. It is no wonder that local people are up in arms about the plans.

The STP for Cheshire and Merseyside appears to set a great deal of store by the development of ACOs, or accountable care organisations. These are an idea brought from America, where of course there is no national health service. They integrate health and social care, and have a strong emphasis on cost reduction. The core issue is that people in England often pay for social care, but certainly do not expect to pay for healthcare, other than through direct taxation. There is real concern that the introduction of ACOs through STPs is part of a desire on the part of the Government to introduce a private insurance-based healthcare system in England instead of our national health service. I would be grateful if the Minister could give some clarification on that point.

It is my belief that the Government are cutting the supply of healthcare in the public sector to create demand for a private health insurance marketplace like the one in America, and there is nothing in the STP to reassure me that that is not the case. The document is riddled with the language of the market, talking of increased customer satisfaction, better user experience and “commercially sustainable” clinical support services. If the STPs go ahead across England, we can expect to see A&E closures, hospital closures, downgrading of services, patients waiting longer for treatment, and deterioration in the pay and conditions of staff as the drive to cut costs takes its toll. I urge the Government to use the autumn statement to address the underfunding of the NHS and to give it the funds it needs.

[Madam Deputy Speaker (Natascha Engel)]

May I just make an apology to Hansard? It is one thing reading a speech, but that was a record level of reading into the record. I appreciate that time is short and that the hon. Lady wanted to put those things on the record, but if she speaks a little bit slower and allows other Members to understand what she is saying, it will give them an opportunity to intervene and she will gain some extra time.

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[David T. C. Davies (Monmouth) (Con)]

I am very pleased to pick up where the hon. Member for Tooting (Dr Allin-Khan) left off. Quite frankly, I find it extraordinary that Labour Members have the audacity to come into the Chamber and trumpet their views about the national health service when they know that they have had 18 years of running the NHS in another part of the United Kingdom and that, on any of the performance indicators that are looked at, the NHS in Wales is performing less well than the NHS in England. I do not for one minute want anyone to think that I am criticising NHS staff—the nurses and doctors—because I am not, and I am not running down Wales either, because I know exactly where the blame lies. It lies at the feet of the Labour party for implementing exactly the same policies that Labour Members are now calling on the Minister to implement.

There is no need to take my word, or that of any Conservative, for this; one can simply get hold of the Nuffield Trust report on “The four health systems of the United Kingdom: how do they compare?” This independent report looked at a range of indicators, and it makes this very clear. I am very happy to read from the report, which in its own way is far stronger than anything the Conservative party could publish. It says that waiting times in Wales have lengthened since 2010, with striking rises in waits for common procedures such as knee and hip replacements. When language such as “striking rises” is used, surely people should take notice of the report, especially when, as Labour Members must realise, those striking rises are being caused by the policies they are asking my hon. Friends to implement.

The report talks about how amenable mortality rates are lowest in England. In other words, people live longer in England. It also talks about waiting times, which are an absolute disgrace. There is a target waiting time of 26 weeks in Wales, whereas it is just 18 weeks in England. More than that, the report shows that some people are waiting for up to 170 days for knee and hip replacements in Wales, as opposed to just 70 days in England.

The report shows that funding in Wales has been cut in real terms. Wales is the only part of the United Kingdom where funding for the national health service has been reduced; in England it has been going up.

The report shows that there is a shortage of GPs. My hon. Friends have increased the number of GPs to 0.75 per 1,000 people, compared with 0.66 per 1,000 in Wales. On stroke care, 39% of patients spent 90% of their time in a stroke unit, as opposed to 51% of patients in England—a much higher amount. The figures for MRSA show, once again, that England is ahead of Wales. The figures for ambulance response times show that 75% of ambulances make it within eight minutes in England, as opposed to 65% in Wales.

Perhaps one of the most shocking differentials in service between England and Wales is in the access to cancer drugs. Constituents have come to see me because they have had to go sofa-surfing with relatives in England to get access to standards of care that patients on this side of the border take for granted.

I issue a challenge to everyone in this House. If Opposition Members think that the Welsh NHS, the policies of which they want to follow, is as good as the English national health service, they should allow patients to choose. I constantly write to my colleagues on the Front Bench asking them to allow patients from Wales to access the national health service that they are delivering so well in England. Unfortunately, it is not always possible to do so. We should have a truly national health service that allows people in Wales to go and be treated in England if they want and, indeed, people in England to be treated in Wales if they want, and adjust the block grant accordingly.

In the meantime, I very much hope that my hon. Friends will stick with the policies that are delivering higher standards of healthcare in England because, if nothing else, it means that my constituents have something to aim for and can demand that the Labour party in Wales follows the successful policies that are being followed in England.

[Madam Deputy Speaker (Natascha Engel)]

A couple of Members who were on the list are not in the Chamber and will be written to. That means that the last two speakers have up to six minutes each.

Social Care

Natascha Engel Excerpts

Wednesday 16th November 2016 Commons Chamber

[Mr Hunt]

We are doing work, and I would simply say that we have also delivered on that promise because we have introduced the deferred payment scheme, which means that no one will need to sell their home because of social care costs.

I will wind up now, because I know that many hon. Members want to speak. When we have local authorities and the NHS working together, what is our objective from that process? We want a seamless transition for patients between the health and social care system. We want shared electronic health records so that patients are not asked the same questions time after time. We want a single assessment system so that people are not assessed twice by different organisations trying to get different results. We want to see the pooling of budgets, we want to get rid of delayed transfers of care, and we want multidisciplinary teams. Most importantly, we want there to be a single plan for every vulnerable person, to which everyone who is involved in their care adheres. Those are the objectives.

In the face of enormous pressure, the best solution for local authorities and local NHS organisations that are finding things challenging right now is not to slow down those vital changes, but to accelerate the pace of change, so that we eliminate waste and improve patient care at the same time. Councils that do so will have the full support of the Government. I urge the House to support the Government’s amendment.

[Madam Deputy Speaker (Natascha Engel)]

Before I call the next speaker, I will have to impose a seven-minute limit. I have to warn Members that the more interventions that are taken, the more that limit will have to come down.

Community Pharmacies

Natascha Engel Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Before I call the next speaker, let me say that there will be a limit of five minutes on Back-Bench speeches. There are 25 people who are trying to take part in this debate, so it may be necessary to drop down that time a bit further later on, but let us start with five minutes.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. I am afraid that the limit has to be dropped to four minutes.

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[Derek Thomas (St Ives) (Con)]

We are all aware of the letter received by pharmacists on 17 December last year, in which the Department of Health discussed the potential for far greater use of community pharmacies and pharmacists. The letter referred to community pharmacists’ role in preventive care, in support for healthy living, in support for self-care for minor ailments and long-term conditions, in medication reviews in care homes and as part of a more integrated local care model. The letter also informed us of plans to reduce funding by £170 million.

I was fortunate enough to be the first MP to raise the matter in a Westminster Hall debate at the beginning of this year. I raised the concerns of community pharmacists about their funding as the plan progressed, as it was intended to do by October 2016. That all came about because the issue was raised in a constituency surgery that I held in St Ives at the start of January. Since then, the general public have been very engaged in this, and they are concerned about the future of their pharmacies. I joined others in this House to present a petition with 2 million signatures to No. 10 in the summer.

I represent a Cornish seat where every effort is being made to integrate health and social care, and community pharmacists see themselves as essential players in a new, modern national health service that is equipped to meet the demands placed on it by today’s society. Community pharmacy is valued and depended on, and it can embrace new clinical responsibilities and meet the demands of an ageing population, but the sector is looking to Government for some reassurance about its future, particularly regarding funding for community pharmacy.

In my constituency, I have several independent community pharmacists. That is because my patch is large and includes areas of social deprivation, which has an inherent impact on health. A car journey from the north to the south of my constituency takes an hour, and a journey from the most westerly point to the most southerly point takes an hour and nine minutes. In a rural area such as mine, community pharmacists provide invaluable access to the NHS and invaluable support to vulnerable people. I am reassured by the fact that the Government have indicated that some protection will be given to rural pharmacies and those in deprived rural areas. That is welcome indeed.

However, funding of community pharmacy remains a concern, and the community pharmacy sector has called for the Department of Health to use funds cut from the community pharmacy budget to fund a minor ailments service from 2017. The service would allow eligible people with a list of common health complaints to visit their pharmacy for advice and, where appropriate, medicines at no cost. That could create significant savings for the NHS by ensuring that patients with minor conditions use pharmacies, thereby preventing unnecessary GP appointments and A&E attendances.

I am well aware of the need to secure better value for money in areas of the NHS. In Cornwall and the Isles of Scilly we are actively involved in drawing up our STP, as directed by NHS England. The NHS has outlined this approach to ensure that health and care services are built around the needs of local populations. I believe that that provides the best opportunity to integrate health and social care in a meaningful way, reduce the pressure on acute services and avoid unnecessary hospital admissions. I also believe that the community pharmacy is central to achieving that objective.

I am aware of the time, so I will just ask a few questions of the Minister. Can the Minister give more details about what support will be given to rural independent community pharmacies and those in deprived areas, many of which operate in Cornwall? Will the Minister comment on the community pharmacy forward view, and the Department’s response to the vision set out by community pharmacy—

[Madam Deputy Speaker (Natascha Engel)]

Order.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

I give advance notice that, after the next speech, we will have to drop the time limit for speeches to three minutes. Even then, things will be quite tight if Members use all their intervention time.

Hormone Pregnancy Tests

Natascha Engel Excerpts

Thursday 13th October 2016 Commons Chamber

[Hannah Bardell]

I could not agree more with my hon. Friend. Many families around the world do not have the answers. Their children have been affected and it is nothing short of a scandal that, many, many years later, they still do not know. It is therefore very important that we ensure the inquiry is effective and ask what other steps we can take.

I ask the Minister to consider whether the scope of the inquiry should be increased to look at why it was apparently hidden that the drug was known to be potentially unsafe in the 1960s or even earlier. I should mention the eight years—this has been mentioned by other hon. Members—from 1967, when the adverse reaction committee advised that there was cause for further investigation of Primodos, to 1975, when the Committee on Safety of Medicines actually issued its warning. The Minister may also be interested to know that Norway and Sweden banned hormone pregnancy test products in 1970. In Norway, it was said to be blacklisted after evidence was submitted that the test caused foetal malformations. Finland banned it in 1971. Germany issued a warning notice in 1972, the USA in 1973, Australia, Ireland and the Netherlands in early 1975, and the UK, finally, on 4 June 1975. Notably, a document shows a comment by a Dr Inman on 15 October 1975 stating that

“we are defenceless in the matter of the eight year delay”.

The families affected are now concerned about this inquiry being a whitewash. They are concerned about a Hillsborough-style situation where there have been years of cover-ups and an inability to get information they have asked for repeatedly. In early July of this year, an article in the German newspaper Der Spiegel reported from old court files that it had gained access to:

“Schering was warned in the late sixties by various animal tests. They had knowledge of possible side effects of this hormone drug.”

Tests were conducted with different dosages, with the result that some dosages resulted in disabilities and the death of foetuses. Other tests showed that animals showed weight loss. In 1971, a scientist recorded that a test dose was

“highly embryotoxic and a cause of early cell death.”

Earlier this year, a major radio station in Germany broadcast a 45-minute documentary on Primodos. Here are just some brief extracts of the stories told:

“My name is Petra Marek and my mother has taken Duogynon as a pregnancy test, but was unaware of what consequences this would have”—

[Madam Deputy Speaker (Natascha Engel)]

Order. I remind the hon. Lady that she is a Front-Bench spokesperson and this is a Back-Bench debate. I am already going to have to impose an informal time limit of 10 minutes per speaker. If she could start to get to the end of her speech, we would all be very grateful.

[Hannah Bardell]

Thank you, Madam Deputy Speaker. I will wind up my comments as quickly as I can.

Another said:

“My name is Birgit Rothlaender. I am almost 50 years old, I have a deformation of my genitals and I have a colostomy for the last 43 years. I think enough is enough, I would like to get 100% confirmation on what happened.”

Let me be clear that for the families who have suffered for decades, this is not about money. It is absolutely about unveiling the truth. The Scottish Government have raised and continue to raise the issue of the independent panel with the UK Government and the MHRA. Public money is being used for this inquiry and it would be an absolute dereliction of duty if it was misused. We must ensure that we do right by the victims of Primodos. We must have an effective inquiry and get the answers for the families which they so desperately need.

NHS Sustainability and Transformation Plans

Natascha Engel Excerpts

Wednesday 14th September 2016 Commons Chamber

[Maria Caulfield]

Absolutely, and £240,000—

[Madam Deputy Speaker (Natascha Engel)]

Order. Andy Slaughter.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Before I call the next Member, let me say that the person after the next speaker will go down to three minutes, and I encourage no interventions in order to get everybody in.

Defending Public Services

Natascha Engel Excerpts

Monday 23rd May 2016 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. I warn Back Benchers that after the SNP spokesman, I will impose a 10-minute limit on speeches.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Natascha Engel)]

Order. Before I call the next speaker, I am afraid that I will have to lower the speech limit to eight minutes to ensure that everybody can get in. I call Paul Blomfield.