(5 years, 5 months ago)
Commons ChamberAs I said to the hon. Gentleman and other hon. Members in the Westminster Hall debate on the drug, a deal is the preferred option. However, the attitude taken by Vertex, which has been called an outlier in this situation, means that my right hon. Friend the Health Secretary has instructed NHS England to look at other options.
Over the past three years, all of us in this House have heard the numerous calls for Orkambi to be made available to cystic fibrosis patients. The Minister could go down in history if she takes the all-important step this week, while still in her job—I hope she will still be in the job tomorrow—of announcing an alternative route to access cystic fibrosis drugs, such as a Crown use licence or clinical trials. Today, before we break for recess, will she commit to that so that families can have Orkambi now?
The National Institute for Health and Care Excellence process is important, because it is an independent expert review and the way in which we allocate resources sensibly. The Crown use licence is not a quick or easy solution, and it is open to legal challenge, which might delay things even more. Vertex has been offered the biggest settlement in NHS history, and I urge the company to accept it. However—I have said this on numerous occasions from this Dispatch Box and in Westminster Hall—the Secretary of State has urged and asked NHS England to look at other options, such as the ones to which the shadow Minister has referred.
(5 years, 5 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
I thank my hon. Friend for his questions. I will attempt to answer all of them.
In terms of governance, no, NICE is not above accountability. Ministers set the framework for NICE, which is a non-departmental body. The reason it was established was to have fairness—so that there was no postcode lottery on access to various drugs. It is important that medical experts and scientists make these decisions rather than politicians. Regular governance meetings are held between the Department and NICE. There is a framework agreement. Where the Secretary of State considers that NICE is failing, or has failed, to discharge its functions or to do so properly, he can direct NICE to discharge functions. If NICE were to fail to comply with the Secretary of State’s direction in those circumstances, he could discharge such functions himself. There is therefore a strong and robust governance system with regard to NICE.
It is not always very helpful to use other jurisdictions as a comparison because we do not know the exact price that has been agreed. In addition, different systems have different healthcare populations and do not necessarily have the equivalent of our national health service.
Turning to access to Brineura, I pay tribute to my hon. Friend and to Max’s family. I know from the very moving testimony by him and by other hon. Members such as the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) and from speaking to my constituent Melanie on numerous occasions that this is an absolutely dreadful disease. That is why we want the NICE process to be able to bring drugs to market as quickly as possible. Drug companies find this drug difficult to develop—that it is very expensive. It is not necessarily a drug that will be paid for by having millions of sufferers globally, and therefore a different system needs to be in place. That is why the bar for QALY is so much higher.
My hon. Friend’s suggestion on arbitration is very interesting, and I will take it away. On NHS England and the negative procedure, yes, in theory we could do that, but it is unlikely if NICE does not recommend a process. Overall, where a drugs company and NICE are unable to come to an agreement—we see this with other medication as well—Ministers urge the company to carry on negotiating to have a fair price, because every pound spent on one drug is a pound that we cannot spend on a drug for another sick person.
Thank you, Mr Speaker, for granting this urgent question. I thank and congratulate the hon. Member for North East Somerset (Mr Rees-Mogg) for securing it following his Adjournment debate last week. I do not doubt that he would have preferred the Minister to have come before the House voluntarily, rather than being forced to come here today for his urgent question.
Time and again, we come to this place to talk about a drug and its benefits to patients, only to be told that no matter how good it is, people cannot access it on the NHS. Among all the politics, there are people, including children like Max, who are suffering. No parent wants to hear a critical diagnosis for their child who has not yet really experienced childhood, let alone reached adulthood.
As we have heard, Brineura, a drug made available by BioMarin, could stop the progression of Batten disease. An assessment by NICE has found that Brineura could provide 30 extra years of good-quality life to patients. But, as has become expected when we discuss drugs for rare diseases in this place, Brineura is not available for patients on the NHS. NICE confirmed earlier this year that it was unable to recommend the use of Brineura on the NHS because of cost-effectiveness. The drug costs over £500,000 per person for each year’s treatment. BioMarin has another drug for rare diseases—Kuvan, for patients with phenylketonuria, or PKU. PKU patients do not have access to Kuvan, because it is also deemed not to be cost-effective. Does the Minister agree that the NICE appraisal process is just not fit for purpose when it comes to assessing the suitability of drugs and treatments for rare diseases?
Access to Brineura would help to give patients and families their child back, and it would allow them to enjoy time with their child and treasure special moments with them. As time ticks on without access to the drug, parents will witness their child’s condition deteriorate. No parent wants to see that, so we really need an appraisal process that captures rare diseases effectively.
Will the Minister step in and personally urge BioMarin, NHS England and NICE to meet and come to an agreement? Families do not want just warm words from the Minister; they want and need access to medicines now. I hope that this urgent question will result in real change in how we address rare diseases.
In answer to my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), I urged BioMarin to get back around the table with NHSE and NICE and come to a fair and reasonable price. NICE has already approved drugs for 75% of rare diseases through its technology appraisal programme, including drugs for idiopathic pulmonary fibrosis and neuroblastoma. NICE’s process and review methods are constantly reviewed, and they are internationally respected. NICE knows that it has to keep up to date with developments in science, medicine and healthcare. There is a periodic review going on at the moment, and that includes extensive engagement with stakeholders.
(5 years, 6 months ago)
Commons ChamberThank you, Mr Speaker. The Government’s second childhood obesity plan will celebrate its first birthday a week today, but we will not be celebrating. The Government have ducked and dived on their responsibility to the children in this country and have failed to produce any policies as a result of the six consultations the plan has promised, but the rate of childhood obesity is still at a record high. Instead of waiting for the chief medical officer to report on obesity, will the Government act now to tackle the childhood obesity crisis, and introduce and implement the policies they have consulted on already?
We have a very ambitious aim to halve childhood obesity by 2030. We are still considering all the answers to the consultations, and we are hoping to respond to them very shortly.
(5 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
It is a great pleasure to serve under your chairmanship, Mr Owen. I thank the right hon. Member for North Durham (Mr Jones) for raising this important issue, and the hon. Members for Sedgefield (Phil Wilson) and for City of Durham (Dr Blackman-Woods) for their contributions.
The Government fully appreciate the importance of protecting and improving the health of the population. We share hon. Members’ commitment to prevention and public health, which this debate has highlighted. The costs, both to individual lives and to the NHS, are simply too great to ignore.
The population in England is growing, ageing and diversifying rapidly. Some 40% of morbidity is preventable, and 60% of 60-year-olds have at least one long-term condition. Helping people to stay well, in work and in their own homes for longer is vital. As hon. Members have highlighted, the gap in healthy life expectancy between the most and least deprived areas of England is approximately 19 years for both sexes. As somebody who was born in Lancashire and represents a Lancashire seat, I see that disparity in my constituency. It is a great motivating factor for me in my role, as it was for my right hon. Friend the Prime Minister when she set her grand challenge of extending a person’s period of healthy, independent and active life by five years by 2035.
However, we will not achieve that by simply adding five extra years at the end of life; as with many things, the earlier we start, the more we stand to gain. Investment in early years and onwards is essential if we want positively to influence future lifestyle choices, prevent disabling conditions and enable people to contribute fully to society. We must continue to focus our efforts on areas such as digital technology and behavioural science so that we can show the public that the healthy choice is the easy choice.
We are doing work—on childhood obesity, smoking, air quality and more—that has the potential to make a real difference to people’s health and wellbeing. The amount of sugar in drinks has been reduced by 11% and average calories per portion have been cut by 6% in response to our soft drinks industry levy. By 2020, the NHS diabetes prevention programme will support 100,000 people at risk of diabetes each year across England. Last year’s ambitious prevention vision statement and the forthcoming prevention Green Paper will enable us to meet the ageing grand challenge and address health inequalities, supporting people to live longer, healthier lives.
We recognise that the funding position for local authorities is extremely challenging and understand the huge efforts that local government has made to focus on securing best value for every pound it spends. The 2015 spending review made available £16 billion of funding for local authorities in England over the five-year period. I remind the House that that is in addition to the money the NHS spends, which is part of the public health offer on prevention and includes our world-leading screening and immunisation programme and the world’s first national diabetes prevention programme.
Today’s debate has highlighted an important issue about the distribution of funding for local authority public health functions. Historically, funding for public health services in the NHS was left to local decision and was not necessarily based on need, which led to wide disparities in the amount of funding dedicated locally to public health services. Before these functions were transferred to local government, we asked the independent Advisory Committee on Resource Allocation to develop a needs-based formula for the distribution of the public health grant. The introduction of that formula meant that some local authorities received more than their target allocation under the ACRA formula and others received funding under target. In 2013-14 and 2014-15, when the overall grant was subject to growth, local authorities’ funding was iterated closer to their target through a mechanism called “pace of change”.
In 2015, ACRA was asked to update the formula to take account of the transfer of responsibility for commissioning health visiting services from NHS England to local authorities. We consulted on this formula and ACRA made recommendations to Government in 2016. I understand that the public health formula is more heavily weighted towards deprivation than either the adult social care formula or the clinical commissioning group formulation.
Of course we want evidence. The shadow Minister says from a sedentary position that it is not working. We did an impact assessment in 2015-16 and we are reviewing all the evidence in preparation for the next spending review.
Just for clarification, did the Minister actually say that the formula is not working?
(5 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
I thank the hon. Gentleman for his intervention. As my hon. Friend the Member for Sutton and Cheam said in his opening speech, which was very well made, we recognise the importance of British pharmaceutical companies and that companies invest hugely in developing new drugs. However, as the other examples of drugs for rare diseases that I have given show, it is possible to go through the NICE appraisal process and reach an agreement with NHS England. As one hon. Member who is no longer in their place said, this is an offer for a long-term agreement.
Vertex is an outlier, and I would like to put that on the record.
Yes, and I hope that I will be able to remember the hon. Lady’s question.
At this point I should clarify, for the benefit of the campaigners who I have spoken to about the Crown use licensing option, that it is not an immediate solution from their point of view; I understand that it would take at least a couple of years. If an agreement can be reached, there would be an immediate outcome. That is why the campaign is called Orkambi Now; it is about trying to get the drug now. Although the Crown use licensing option would be an option to consider if nothing else can be found, it would not give the sufferers and their families the drugs as quickly as we would like.
As always, the shadow Minister makes an excellent point. Crown use licensing is not something that any Government would consider lightly. It is very rarely used in health. It has probably not been used—my officials will correct me if I am wrong—since the 1970s.
The ideal thing is to get a deal, and deals have been done with other pharmaceutical companies; that is the point I want to make. As I have said, Vertex is an outlier in this regard, but that does not mean that I do not have an obligation to look at other options. I will do that.