Medicines and Medical Devices Bill
Debate between Philippa Whitford and Chris GreenMonday 2nd March 2020
(4 years, 8 months ago)
Commons ChamberRead Full debate Medicines and Medical Devices Act 2021 View all Medicines and Medical Devices Act 2021 Debates Read Hansard Text Read Debate Ministerial Extracts
Chris Green (Bolton West) (Con)
It is a pleasure to follow the hon. Member for Leicester South (Jonathan Ashworth) and to speak in this important debate. This is an immensely important subject of great national interest. In the context of leaving the European Union, the Bill will allow existing European Union regulations on medicines and medical devices to be transposed into UK law. The Bill is closely linked to the timings of the transition period as we leave the EU—and perhaps to any extension, which we hope to avoid.
I welcome the Bill’s principal thrust, which is to remove unnecessary bureaucracy for the lowest risk clinical trials, to encourage the rapid introduction of new medicines, to ensure patient safety by combating counterfeit medicines, and to extend the UK’s global lead in personalised medicines and artificial intelligence in health. Ultimately, all those concerns link up to what ought to be our principal focus in this debate: better patient outcomes and creating a healthier society.
Many people would be surprised to hear just what a contribution the life sciences sector makes to the UK economy. It encompasses pharmaceuticals, medical devices and medical technology, and it is worth over £74 billion per annum. The sector also employs close to 250,000 people in the UK. Many of those jobs are often secure, and are highly skilled and highly qualified. We will shortly introduce an immigration Bill. It is right that we focus on the skills and the contribution people can make to the UK. Bringing more people to the UK with PhDs and STEM—science, technology, engineering and maths—qualifications ought to complement and enhance the support of our life sciences sector. The more we hear about technicians, engineers and scientists who want to come to the UK, the more it will be a really positive thing not only for the sector but for immigration to the UK as a whole, and how people perceive it.
Dr Whitford
Does the hon. Gentleman recognise that young graduates with a degree or a PhD, technologists and researchers often do not earn more than the threshold the Government have set for a visa?
Chris Green
That is a significant concern. The Government have reduced the starting point in the immigration Bill from £30,000 to about £25,000 and I believe the points-based system will have the flexibility we require, but those areas should be judged and reviewed as time goes on. Certainly in these sectors we want highly qualified, highly skilled and highly experienced people to come to the UK.
One big concern in medicine is data. A lot of what we do in medicine falls into the category of big data: the acquisition, transmission, storage and application of that data. This is a really interesting time for technology. The devices themselves are able to generate good quality data. As has been highlighted, it is now so much easier for personal devices to be worn not just for a few hours or a couple of days, but for a long period of time. People are now able to go about their daily lives in a normal way, whether they are exercising or doing something as basic as having a shower. Some devices could not previously cope with people taking exercise or having a shower, but increasingly, devices are able to cope. They can amass a vast amount of data. It is pretty much impossible for a clinician or a GP to judge such a huge wealth of data, so we are increasingly looking at how GPs and hospital consultants can use artificial intelligence and other methods to give them a helping hand in carrying out the assessments. They might end up with tens of thousands of pages of data and a consultant just will not have time to consider it all. Using artificial intelligence could help them to do the assessments and come to conclusions.
Chris Green
That is a vital and well-made point. Data can empower the individual. They can have more detailed access to their own records and their own data. The data generated by someone wearing a device day in, day out, week in, week out can be transmitted to a consultant, who can call a patient more promptly if there is anything a little worrying. If there is a heart murmur or someone feels a bit dizzy, the person can register that concern at that moment. That is useful information for the clinician, who will be able to recognise when someone’s lifestyle has aggravated a condition. There are many ways that the data can be used. I think we are in relatively early days. I am not sure I would include Fitbits and that kind of technology—there is far more interesting and advanced technology—but it is important that people are increasingly engaged.
There is a concern about the embrace of technology, devices and data, and the streamlining of processes in hospitals. The contribution of individuals, GPs and consultants provides an opportunity to consider a more engaged approach to hospital and GP services in a way that could reduce the number of appointments that are necessary. Some hospital trusts have a chief innovation officer on their board. I think there are about 20 across the country, which is a relatively small proportion. It may be worth considering what the Minister can do to promote that. Ideally, we need the early adoption of approved medicines in the system. This is where the register ought to help. If we can have people in hospital trusts leading and championing the adoption of new technologies, providing information and insight, perhaps we can give more confidence to chairmen and boards as a whole. We could then have more trusts adopting technologies. We could therefore support the industry and patients, and get them the medical treatment they need earlier.
Dr Whitford
That might well be the case with gadgets, devices or new digital apps, but with new drugs, it is usually the clinicians who are desperate to get their hands on them. Most new drugs, particularly for challenging conditions such as cancer, are expensive and it will be several years before they are passed by NICE in England or the Scottish Medicine Consortium. The delay is not the clinicians not wanting access; it is the cost of introducing them.
Dr Philippa Whitford (Central Ayrshire) (SNP)
The Bill is necessary because of Brexit, as the UK is losing the European Medicines Agency—one of the great advantages was working together to have a single licensing system that licensed new drugs right across Europe. As the hon. Member for Bolton West (Chris Green) described, it is about working with other countries to avoid duplication and to speed up getting new drugs from the laboratory to patients who need them.
The problem is that manufacturers will have to apply separately to the UK, which means extra processes and additional costs. It is important, therefore, that whatever system is adopted is as similar to the EU as possible and does not ask for a whole different set of work-up, investigation and paperwork, or that will put manufacturers off launching their drugs in the UK. The same issues apply to veterinary medicines, hence they are in the Bill.
The simple fact is that the EU is a market of 500 million people—a quarter of the world pharmaceutical market. The UK on its own is only 3%, which is why drugs tend to be launched in the US and Europe at the same time. In all my 33 years on the frontline, I saw an acceleration of drugs getting from the bench top to the patient, because of the EU and the European Medicines Agency. This means that there are likely to be delays for patients. Canada and Australia wait another six to 12 months before drugs are launched there, so how will the Government avoid a delay in patient access, particularly for new drugs from outside the UK and for conditions such as cancer, where patients are literally waiting for the drug?
Chris Green
I realise that this is a distinct area, but does the hon. Lady share my concern that sometimes the EU as a whole is quite slow at reform—for example, with the clinical trials directive and the clinical trials regulation? The CTD was first devised in 2001. We are now in 2020 and we have not yet updated it. Industry and wider sectors would like the update to happen, but it is taking a very long time.
Dr Whitford
I thank the hon. Gentleman for that point. When we are trying to collaborate and get a group of 28 countries—indeed, 31 countries, because the European economic area is involved—to all agree to such enormous changes, with legal ramifications for their drug and device producers, and so on, it takes time, but in the end, I think it will be worth it. Of course, I would have liked it earlier. Having been involved in breast cancer trials, I know that the clinical trials directive was clunky and bureaucratic, but it is being changed.
Vaccination and Public Health
Debate between Philippa Whitford and Chris Green(5 years, 5 months ago)
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Chris Green
I wholeheartedly agree with my hon. Friend. When I was young, I had both chickenpox and measles. At that time, it was part of growing up, and many people who have had those diseases think, “It’s not a big thing; it’s not a big problem.” However, serious health outcomes or problems can develop from diseases that people may dismiss as not being terribly important. In that sense, solidarity is vital; we must all take responsibility not only for ourselves and our own families, but for the wider community.
Media and social media concerns are just one factor. There are a number of other barriers to achieving comprehensive vaccination. The World Health Organisation highlights vaccine hesitancy, and identifies three Cs: confidence, complacency and convenience. Is it convenient to have the vaccination? Are people confident or complacent about take-up, with a sense of, “I’ll be one of the 5%,” or, “It’s not really a problem in our society; the treatment isn’t actually dealing with a significant problem”? Or do people think that the disease has gone the way of smallpox and been effectively eradicated? That is not the case, especially given the ease with which people can travel across the world.
The UK is a leader in what we do here, but our support for countries around the world is also incredibly important. Support for funding the Department for International Development is often challenging, but I think there will be pretty much universal support for the announcement earlier this year of the £10 million to develop vaccines against global infectious diseases. That came on the back of the Ebola crisis in west Africa, where 11,000 people were killed, and it goes into a wider fund of £120 million committed to infectious diseases. The UK is the single largest contributor to Gavi, contributing a quarter of its funding and saving hundreds of thousands of lives around the world.
The UK also has an important role to play in co-ordinating and helping other countries. If another country does not have the health infrastructure that we have, they will need that support—that was the case in the Ebola example in west Africa—and we can lend our expertise. I reiterate that with flights from west Africa to the UK, Europe and the rest of the world, the transition of easily communicable diseases is a significant risk.
Dr Philippa Whitford (Central Ayrshire) (SNP)
It is great that the hon. Gentleman has secured the debate.
Geraint Davies (in the Chair)
Order. According to the rules, Front-Bench spokespeople are not supposed to intervene in half-hour debates, but if Chris Green is happy to take that intervention, I will allow it. I just thought that I needed to put that on the record.
Dr Whitford
As chair of the all-party parliamentary group on vaccinations for all, I was very disappointed that our debate in the Chamber sadly clashed with the local government elections and was therefore poorly supported. I welcome the hon. Gentleman’s comment on health systems. A huge amount of work has been done on eradication, but less than 10% of children have had their full World Health Organisation vaccinations. Thankfully, the big global players are beginning to see that it is about universal health coverage and routine vaccination.
Chris Green
Absolutely; those comments are so important. I recognise the hon. Lady’s chairmanship of the all-party parliamentary group on vaccinations for all, which is a really important group.
There has been a slight decline in the UK in the take-up of vaccinations. Is the Minister concerned that recent healthcare reforms have inadvertently contributed to the decline in vaccination rates, as highlighted by the British Medical Association? The loss of care roles—such as primary care trust immunisation co-ordinators, who provide training as well as co-ordination—occurred as responsibility was moved away from primary care trusts.
Turning around the gradual decline in vaccination coverage is likely to involve the provision of more accessible services and more active outreach by health professionals into individual under-vaccinated communities; the wider provision of vaccination services, through things such as school visits by community nurses and mobile vaccination services; better training of health professionals on what vaccines are, what they do, how they work and what is in them, so that those professionals are ably equipped to answer parents’ questions; increasing public awareness of the benefits that vaccines confer and the danger that the return of vaccine-preventable diseases poses; provision of the right public health funding to enable vaccination services to function effectively, including by reaching under-vaccinated groups, which costs more than standard provision; and communicating with parents to improve their access to evidence-based information. By implementing some, if not all, of those ideas, we will help to address the difficulties that are leading to a fall in vaccination rates, and make a positive case for why immunisation is good for public health.
This debate is timely, given that NHS England is currently undertaking a review of GP-led vaccinations and immunisations. The review was first announced in January as part of the NHS long-term plan, but it began properly only in the last six weeks. The purpose of the review is to consider how screening and vaccination programmes could be designed to support the narrowing of health inequalities, as well as to reduce complexity, improve value and increase the impact of the current vaccination programmes delivered by general practices. That includes reducing the administrative burden on GPs by simplifying the system, addressing the anomalies in the system that directly incentivise some vaccines but not others, and looking at how we deal with outbreaks and catch-up programmes.
The review is a perfect opportunity to assess how each vaccine programme is performing and to address and improve underperforming programmes. There are also opportunities to streamline the system and introduce a consistent approach. For example, some programmes, such as flu and pneumococcal programmes, include call and recall measures to boost uptake, but that is not the case for other programmes, such as shingles.
Community pharmacies have a really important role, and they could make an important contribution to vaccination. They are a convenient way for people to address their healthcare and receive vaccination services, perhaps without the need for an appointment. Many community pharmacies in England already deliver the NHS flu vaccination service, which has proved popular among patients. Following that success, would it not be possible to provide a wider range of vaccines in that way? That would help people to remain healthy, and it would reduce GP’s workload and the wider pressure on the health service.
Community pharmacies are uniquely positioned to help the NHS to meet its immunisation targets in England, and to help to ensure that people in more deprived communities receive the vaccinations they need. In contrast to other healthcare settings, there is a greater density of pharmacies in the most deprived areas per head of the population, making pharmacies ideal for bridging the gap in areas where people face greater health inequalities.
I reiterate that the UK has a strong history of vaccinations, from being the country that invented the first ever vaccine to becoming a truly global player in creating a healthier world for everyone to live in. However, we must take stock of vaccination levels here at home, and we must not allow complacency or misinformation to reduce the level of immunisation. We must continue to strive for the highest levels of immunisation, so that our children continue to enjoy living in a healthy society free from disease. I thank the British Society for Immunology, Save the Children and the Pharmaceutical Services Negotiating Committee for their help. I am glad that we are having this important debate, and I look forward to hearing from the Minister.