(7 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
We intend to do more to help pharmacists to help with diabetes prevention. Diabetes is one of several long-term conditions that the Murray review is examining. There are ways in which pharmacies can be used to avoid repeat or ad hoc GP appointments, which is precisely what we want to happen, but that is not the same as not keeping under review the amount of money that we pay pharmacists for dispensing, and ensuring that we are getting a good deal.
The right hon. Gentleman said that he agreed with the hon. Member for Kettering (Mr Hollobone). The density of the United Kingdom’s pharmacy network is approximately double the density of networks in Holland, Sweden and Denmark. No one thinks that it should fall to the same level as theirs, but there are opportunities for us to review clustering and ensure that the NHS is receiving value for money, and that is our duty.
I congratulate the hon. Member for Barnsley East (Michael Dugher) on his urgent question, although I am slightly sorry for the excellent Minister, who is having to deal with the question before the Government are prepared to make an announcement. I agree with my hon. Friend the Member for Kettering (Mr Hollobone) that community pharmacies are very important in Northamptonshire, given that the rest of the national health service in our area is under such pressure. If the amount saved is really going to be so small, I urge the Minister to say, “Actually, let’s drop this. It is just not worth the battle.”
I can only repeat that we value the contribution that community pharmacies make, and that the savings that we shall propose shortly are needed for other parts of the NHS. We believe that provision will not be affected, and that other parts of the package, including the integration fund and the hiring of an additional 2,000 pharmacists for the GP sector, will make this sector work better than it does at present.
(8 years, 4 months ago)
Commons ChamberI am extremely grateful to the Minister for his courtesy. On a personal note, may I wish the Minister very well in that important meeting with Deborah Coles? She is a very formidable character, as I know myself, because we knew each other at university. She is very formidable indeed, and I wish him well.
On a point of order, Mr Speaker. We have just had questions to the Secretary of State for Foreign and Commonwealth Affairs. We had an excellent team of Ministers here, but we did not have the Secretary of State. The Minister for Europe made the point that the Secretary of State was on the last leg of an overseas visit. I thought it was a convention of this House that Parliament came first and that Secretaries of State should be here for questions unless an emergency took them away from the House—clearly this trip was planned. Will you give guidance to the House on whether Secretaries of State should be on overseas trips when questions to their Department are scheduled?
Further to that point of order, Mr Speaker. Things may have changed since I was paying attention to this—it is 25 years since I was a Minister—but in my day, a Minister for the Government spoke with the same authority no matter what rank of Minister they were.
(8 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
If there has been correspondence that has not been answered, I apologise, but as the hon. Lady knows from my previous contact with her, she can come and see me, and we will sort that out as soon as we can.
Order. I thank Members for a very important debate, but I am afraid time has beaten us, and we must now move on.
Motion lapsed (Standing Order No. 10(6)).
(8 years, 7 months ago)
Commons ChamberMay I share in the sense of relief? I, too, congratulate my hon. Friend the Member for Daventry (Chris Heaton-Harris). As others have said, it is no mean feat to steer a private Member’s Bill through this House. For all sorts of very good reasons, there are many obstacles to doing so. The process is designed to ensure that only those Bills that command a majority, if not unanimous support, and that clearly address something that the House feels is a priority make it on to the statute book. He has achieved something remarkable in getting this far, although he is right to emphasise that he has only come this far and that the Bill now goes on to the upper House. I pay tribute to his work. Everybody here has acknowledged the quiet, careful, considerate decency and tenacity with which he has got around and listened to people.
I genuinely believe that the Bill will be a powerful mechanism in the new landscape of personalised and precision medicines that we are developing in this country. It will help busy clinicians on the frontline of our health and care sector by making easily available at the click of a mouse information on innovative medicines—both new medicines and innovative uses of existing medicines—that they can prescribe or recommend to their patients.
It is a pleasure to have reached this point, having embarked—somewhat bravely, some of my officials might have said—on a process of supporting the intentions behind three Bills that the House has considered over the past 18 months. I have been determined to work with Back Benchers to reach a solution that the House and the Government could support.
The Bill captures the spirit of two others: the Bill tabled in the other House by Lord Saatchi, which was intended to promote a culture of innovation and innovative medicines in our health system, and the Off-patent Drugs Bill tabled by the hon. Member for Torfaen (Nick Thomas-Symonds), which was intended to promote greater use of off-label and repurposed medicines. My hon. Friend the Member for Daventry intends to promote greater access to information. I pay tribute to all three people, because their work in initiating their Bills has led to the House reaching unanimity.
I thank and pay tribute to the hon. Member for Central Ayrshire (Dr Whitford). Ministers do not always agree strongly with Scottish National party Members, but it is nice to be able to do so on this occasion. She brings to the House a lot of expertise in her field as a medical specialist, and she has played an important role in bringing the Bill to this point. I also thank my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who brings her own experience of surviving cancer and a passion for the subject. The Members I have mentioned and others who have spoken today and in earlier debates have brought us to a much better place, with a Bill that commands and deserves respect and support.
I want to say something about Lord Saatchi, who commenced the debate on this subject. Passing legislation through Parliament is always a messy business. The anti-slavery campaigners took years, and all sorts of legislation that we can look back on with great pride had previously fallen at various hurdles. It takes tenacity to make things happen. This is not the same Bill as Lord Saatchi’s and it does not tackle the issue that he wanted to tackle of some clinicians fearing negligence cases, but I believe that it tackles the central issue that he was trying to address by creating a culture that promotes greater use of innovative medicines. I believe that he has secured, in his way, a legacy for his late wife Josephine that he can be proud of.
Lord Saatchi and Members who have spoken today have become part of a growing movement of patients, charities and campaigners who want us to accelerate access to innovative medicines. I often hear demonstrations from my window in the Department of Health, with patients sometimes chaining themselves to railings. I have yet to hear a demonstration asking us to take longer to regulate and assess drugs and bring them to market. Indeed, the demonstrations that I have heard in the past year have been by patients asking for quicker access to medicines. Mothers whose children have rare diseases have been asking why we are not moving more quickly to bring genomically and infomatically targeted medicines to their children. I have taken part in more debates on this subject than on any other in the past year.
I want to mention a number of people who, appropriately, have been referred to today, including the late Les Halpin. He founded Empower: Access to Medicine with a passion that his death would not be in vain and that his experience of dying from a rare disease would inspire and motivate others to invest more in research and accelerate innovative medicines being brought to patients. The campaign, which was started for him, is continuing to grow and build support for the agenda that we have discussed today.
Graham Hampson Silk has also been mentioned. Ten years ago, he was given four years to live, but because of the extraordinary work of NHS clinicians and NIHR researchers at the Birmingham Institute of Translational Medicine, led by the inspired Professor Charlie Craddock and supported by Cure Leukaemia, Graham is alive. He is using his life to campaign for quicker access to innovative medicines. He is alive because Charlie Craddock got him access to a drug that was in research in America, raised money and flew Graham to the States, and then got the drug into the Institute of Translational Medicine. In fact, that institute has pulled into the greater midlands area more than £20 million of free drugs in trials.
I should mention Emily and a number of the other mothers who have been to my office on a number of occasions in the past six months to discuss muscular dystrophy and Duchenne. The extraordinary progress of our medical community in genomics and informatics unlocks new treatments, but the mothers and fathers of children with rare diseases look on with frustration that we are unable to get the insights to benefit their children and families more quickly. As the first Minister for Life Sciences, I am driven every bit as much by their advocacy, passion and commitment.
The truth is that a lot of people are not interested in this space until they get a diagnosis or until someone in their family gets a diagnosis, at which point people become very interested in research, data and genetics. I am very pleased that their names and a number of others have been mentioned. My hon. Friend the Member for Daventry has struck a small blow in the march of that army for accelerated access to innovative medicines.
I want to say something about the landscape in which the Bill will land, the leadership that the UK is showing to create that landscape and the changes that will benefit patients and our NHS. The truth is that the traditional model of drug discovery is breaking down in front of our very eyes—the very long, 15-year, $2 billion process by which traditional pharmaceutical products are developed and brought to patients. That is too long for the industry and patients, and it is too expensive. Increasingly, the breakthroughs in genomics and informatics mean that drugs can be developed for specific patient groups around specific genetic biomarkers with much greater precision and be brought into the system much more quickly. They do not have to go through 15 years of randomised control trials when there is a genomic biomarker that guarantees they will work in certain patients and informatics to support that claim. That allows us to get medicines into targeted groups much more quickly.
That quiet revolution, which the UK is seeking to develop through our various initiatives, is principally driven by two transformational technologies: genomics and informatics. Genomics allows us to understand the cause of so many diseases—in many cases, the cause is inside the cells in our bodies—and to understand, at scale, why different patients respond to different drugs and why they respond to different diseases in different ways. It also allows us to centre our research on the experience of real patients with real diseases in real time.
Allied with informatics, that allows us to use the NHS to look at huge datasets of patients over the past 20 or 30 years, which is an incredibly powerful resource. Large-scale anonymised data allow us to identify patterns. When we re-analyse the data, we find that many of the drugs that have failed in traditional drug discovery, which could happen because of a side effect, a serious side effect or a death in the late stage of trials when the drug is trialled in the largest number of people, are dream drugs for a small sub-segment of the population. Part of that revolution is about allowing us to identify which patients would have responded much more quickly, which cuts down the time, cost and risk for companies in developing and thus reducing the price. It also cuts down the time that patients have to wait and to have more accurate dosing—we can get the right drug in the right dose to the right patients more quickly.
I put on the record my thanks to my hon. Friend the Member for Daventry (Chris Heaton-Harris) for his success in driving the Bill through. I have heard only today that a constituent of mine is getting a treatment for prostate cancer earlier because of the Minister’s intervention. I am sure that that is part of what the Government are driving. I wanted to thank him for that while I had the opportunity.
My hon. Friend is very kind. I thank him for his comment and am very pleased to hear that news.
We are putting in place various initiatives to support the new agenda, and seeing the beginnings of some successes. On the request made by the hon. Member for Torfaen, I will be happy to write to him about the proposals and how we envisage the measure working. There is quite a lot of work to be done on how the process of using a NICE evidence review to assess the evidence for an off-label claim. I am not prevaricating for any reason other than that I do not want to pre-empt that work, which we are getting on with.
(8 years, 7 months ago)
Commons Chamber8. What his policy is on making docetaxel available as a treatment for prostate cancer.
Docetaxel is routinely available in England for the treatment of metastatic prostate cancer, where the disease has not responded to hormone treatment. It is not at the moment licensed for use alongside hormone treatment and has not been appraised by the National Institute for Health and Care Excellence for that indication. In the absence of NICE guidance, NHS commissioners are free to make funding decisions on the best available evidence.
I thank the Minister for stating the current practice. A constituent of mine has prostate cancer. His doctor, consultant and oncologist all say that he would benefit from taking docetaxel, but it is not available in Northamptonshire, although it is available in parts of the rest of the country. He has been told that if he goes down the road to the private hospital, he can have it at £2,700 a cycle. Is that not unacceptable? Should he not get the treatment on the NHS and should he not get refunded the monies paid for private treatment?
I congratulate my hon. Friend on being a diligent advocate for his constituent Mr Vann. I am delighted to tell him that the result of the STAMPEDE clinical trial has now been published. Today NICE is publishing an evidence review. NHS England will shortly be publishing its interim commissioning policy based on that evidence. That is very encouraging.
(8 years, 8 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My officials have been giving considerable thought to how to do that. A number of people are members of the existing schemes, so we have a means to communicate with them, but it is clear from experience of following up previous inquiries’ recommendations—for example, the one recommendation of the Penrose inquiry—that we make exhaustive efforts to inform everybody. In particular, we will want to inform people who have had a lump sum payment but are not members of the current scheme. We will make exhaustive efforts to inform people by every means possible. Members of Parliament can of course be of great assistance in that regard.
Going back to the issue of medication, my constituents want to know the answer to this question: available drugs that have not yet been approved by NICE but that can be prescribed are not being prescribed locally on financial grounds. Is that not wholly unacceptable?
The NHS is looking at its response to the most recent NICE guideline—it was very recent, on 25 November, from memory. The NHS has commissioning arrangements in place for previous treatments that met NICE guidelines. It would be useful if my hon. Friend contacted me separately about the particular situation in which his constituents find themselves, and we might be able to provide some helpful support.
(8 years, 8 months ago)
Commons ChamberAnaesthetists have an absolutely vital role to play in providing proper seven-day services. In the highest-risk operations it is obviously very important for consultant anaesthetists also to be present, to give their very important judgments. I absolutely give the hon. Gentleman that assurance.
If this disaster is avoided, we have an opportunity to move forward and the hon. Member for Lewisham East (Heidi Alexander), who represents the Opposition, has offered her support. One of the crucial failings in seven-day care is social care. Would it be possible for Members on both sides of the House to work together to find a solution to that real problem?
I hope we can do that. The Opposition have talked regularly about social care, and rightly so. The fact is that both Labour and Conservative-run councils are responsible for the social care system, and being able to discharge into the social care system is a very important part of seven-day services. We are now about to enter a period of important reform in NHS and social care integration, so I see no reason why that approach could not be bipartisan.
(8 years, 9 months ago)
Commons ChamberMy hon. Friend makes a good point and I have urged my hospital trust to make the information available not only online, which always seems to be the catch-all approach of any organisation, but in the hospital, so that patients and visitors do not have to come into the hospital and take up the time of staff and administration staff to clarify something that could easily be set out in a leaflet, a letter or a small poster by a desk.
In Solihull, a reduction in the price of monthly tickets and concessions was the direct response to the lobbying done by me and local councillors. We have also seen a doubling of the free parking time at Solihull hospital from 15 minutes to 30 minutes. At the hospital it can often take up to 15 minutes just to find a space, so I urged the trust to increase this time, and the Heart of England NHS Foundation Trust kindly saw fit to double the time. These are small wins, but they are an example of what can be achieved through individual engagement, by putting our case and understanding that there is not an endless supply of money and that we have to be sensitive to the bottom line—the finances of the NHS—because if we are not careful, we may end up depriving the NHS of vital cash.
My own Heart of England NHS Foundation Trust has a deficit—this is in the public domain—of £29 million for the first five months of the financial year. So seriously is this viewed that the management of the University Hospitals Birmingham has been brought in to help close the black hole in the finances. I welcome that move, but it shows that this is no time to destabilise NHS finances or those of individual hospital trusts in our areas.
My hon. Friend has been generous in giving way. I have listened to the arguments and the one problem I have is this: should we be using car parking charges to fund the NHS? Should we not fund the NHS properly? I am slightly uncomfortable with that.
I understand entirely where my hon. Friend is coming from and in an ideal world I would agree. I would like to see free hospital parking. However, I recognise that there are pressures on our car parks, and that car parking charges at a hospital have to reflect the car parking charges in the local area; otherwise we will have the problem that we encountered in Solihull prior to the introduction of charges, when people were parking at the hospital and then shopping. It is a fine balancing act and it should be dealt with by individual areas on a case-by-case basis.
(8 years, 10 months ago)
Commons ChamberLet me give the hon. Lady the facts. According to an independent study conducted by The BMJ, there are 11,000 excess deaths because we do not staff our hospitals properly at weekends. I think it is my job, and the Government’s job, to deal with that, and to stand up for patients.
The hon. Lady talked about being constructive. There is something constructive that she can do, which is to join the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Nursing, and urge members of the British Medical Association not to strike but to negotiate, which is the sensible, constructive thing to do. Will the hon. Lady tell them to do that?
The question is about the seven-day NHS, but there is no point in our having a seven-day NHS if it is not an NHS across the country. I have a constituent with advanced prostate cancer who, as his oncologist says, needs docetaxel chemotherapy. In fact, all east midlands oncologists say that it is needed, but it is not provided by the NHS in my constituency, although it is provided in Birmingham. If we are to have a seven-day NHS, we need treatment across the board. Will the Secretary of State step in and do something about this?
I will look into the individual case that my hon. Friend has raised, but I think patients recognise that sometimes they need to travel further for the most specialist care, and can receive better care if they do so. However, the way in which what we are doing will help my hon. Friend’s constituents, and other people with cancer, is not just about consultants and junior doctors working at the weekends; it is about seven-day diagnostic tests, which will enable us to get the answers back much more quickly and catch cancers earlier.
(8 years, 10 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
My hon. Friend identifies precisely the action we in the Department need to take. It would be a dereliction of duty to pour money into an unreformed system, as it would mean money being spent on administration, bureaucracy and waste, and not on the changes we need to improve patient care. We need to move at pace to bring in the changes necessary to transform the system if we are to get the NHS we all want to see.
I congratulate the shadow Secretary of State on an excellent urgent question and the Minister on how he has responded. It is interesting that there are more Government Members who want to ask questions. With regard to deficits, we have very expensive and highly paid management and accountants. They set their budgets and then a deficit develops. What action can be taken against these highly paid individuals for not keeping to their budgets?
My hon. Friend raises an important point. There are trusts that are being managed exceptionally well which hit the budgets they set at the beginning of the year. That is the normal course of business for other organisations. This is why my right hon. Friend the Secretary of State introduced the clawback on new chief executive contracts, which mean that if they do not perform according to plan then a proportion of their salary will be docked at the end of the year. That is an important reform, one not introduced by the previous Administration but by us, the party of the NHS.