Cosmetic Surgery

Debate between Stephen Dorrell and Anne Milton

Thursday 5th July 2012 Westminster Hall

[Anne Milton]

Thank you very much, Mr Rosindell. I am also grateful to my hon. Friend the Member for Bosworth (David Tredinnick). I was not aware that we were allowed to run on.

I am grateful to the Liaison Committee for choosing the topic for debate and to my right hon. Friend the Member for Charnwood (Mr Dorrell) for the thoughtful way in which he introduced it. I concur with the statement made by the shadow Minister about the usefulness of the Backbench Business Committee. It has allowed us all to raise issues of interest to our constituents in a much more timely fashion.

I welcome the opportunity to set out the Government’s position. My right hon. Friend described much more eloquently than I could the events that led up to what has happened. The stress that the women concerned have gone through has been immense. I am disappointed that the shadow Minister was slightly party political in her response. The right hon. Member for Rotherham (Mr MacShane) said that the issue is not very party political. I gather from the debate that the matter has been on the stocks since 1994. It is time for us to shine a light—possibly this issue has done so—on cosmetic surgery and, indeed, on interventions. We need to make sure that we get our house in order.

The women concerned believed that they had received breast implants containing silicone that was safe and of medical quality. They certainly did not expect to discover that they had been, in some cases, cruelly and cynically deceived and that their interests had been ignored through the fraudulent activity of the manufacturer. Over the past few months, I have met a number of women with PIP implants. They all feel, as do I, that the right lessons should come from what has happened. In fact, although the women concerned certainly do not want to be in the position they are in, they are keen to know that the Government will learn some lessons.

We should start with the science. I assure the shadow Minister that, of course, as with anything, research and review of practice is ongoing. One does not just carry out a review of research and end it there, because research continues. It is extremely important, and not only in this country, that we continue to learn lessons from ongoing research on a number of issues and that we remain open-minded.

Within weeks of the discovery of the fraud, the MHRA commissioned tests to find whether the material in PIP implants was dangerous. Because of legal difficulties over similar tests in France, the MHRA was the first agency in a position to publish the results of that testing, in September 2010. For obvious reasons, the tests were based on a limited number of samples, but the conclusions at that time were relatively reassuring. More tests were then carried out in France and Australia during 2010 and 2011. The results were broadly similar to ours, apart from some inconsistencies over a test for skin irritation.

Towards the end of 2011, the French regulator began to notice that more people were reporting that their PIP implants had ruptured. There was a report of a rare form of cancer in one woman with a PIP implant. The French cancer institute looked at the data and decided that there was no excess cancer risk associated with PIP implants. Nevertheless, as a precaution, the French Government decided to advise all women with PIP implants to have them removed. A number of European countries followed suit.

We, in the UK, decided that an expert group chaired by the NHS medical director should look at the evidence and advise on appropriate policy for the NHS in England. The expert group delivered an interim report within a matter of days; it advised that the evidence at that time did not justify removing all PIP implants as a matter of course. Instead, the group advised that women should speak to their specialist and come to a decision individually. However, it also noted that the evidence base was not perfect, and said that it would collect more information and advise further in due course. I understand that the Health Committee supported that decision.

I am sorry if the shadow Minister feels that anybody from the Government has not appeared sympathetic. It is certainly not a view I have heard expressed. It would be hard not to sound sympathetic when people have been the victims of what, as I said at the beginning, were the cruel and cynical actions of a fraudulent company. I have met a number of the women concerned since then. I hope not only that lessons will be learned, but that any Government procedures will ensure that responses are more timely.

[Mr Dorrell]

On the evidence of toxicological damage, one of the things that the women most directly affected are seeking is more precise detail about the evidence that has been used by the MHRA to reach its conclusions. Will the Minister clarify whether that is to be published or whether there is a constraint that prevents its publication?

--- Later in debate ---

[Mr Dorrell]

I am sorry, but I am going to have a go at my hon. Friend the Minister, and not on the subject of gold fillings. Her point is that if a provider removes the faulty implant on the NHS and then goes on to provide a paid-for replacement of the implant, the NHS somehow becomes responsible for the ongoing maintenance of the replacement implant. However, that assumes that we consider the provider hospital as the NHS for that purpose. We all know that NHS hospitals provide private care. The NHS does not accept responsibility for that private care. If the patient pays in an NHS hospital for care, it is private care, and the NHS is not responsible for paying for follow-on care. If a patient who happens to be in a private NHS hospital pays for a new implant and that half of the procedure is private, I genuinely do not understand why the NHS would suddenly become responsible for it on an ongoing basis.

[Anne Milton]

That may be a subject for a Backbench Business Committee debate on co-payments and what the NHS is and is not responsible for. The difficulty is—

Oral Answers to Questions

Debate between Stephen Dorrell and Anne Milton

Tuesday 22nd November 2011 Commons Chamber

[Anne Milton]

I am sure that the hon. Gentleman would not want us to rush this. It is extremely important that for the first time we will have a public health outcomes framework. There was no such framework under the previous Government, so it is important that we get it right. It will be an important signal to local authorities about what we expect them to achieve—with, as I have said, a focus on improving the health of the poorest fastest.

[Mr Stephen Dorrell (Charnwood) (Con)]

As we transfer public health responsibilities to local Government—something that has been very broadly welcomed—is it not important that in addition to a clear definition of the funds that are going to be transferred, subject to a ring fence, we also have a clear definition of the responsibilities that local authorities will be expected to discharge in the new world? When can we expect that definition to be put into the public arena?

[Anne Milton]

My right hon. Friend is absolutely right. Conditions will be attached to the ring-fenced money to determine how it can be spent, but any expenditure will need to refer to promoting or protecting public health. I hesitate to use the word “shortly”, which the previous Government used on many occasions, but it will be published along with the outcomes framework. It is important that we get it right.

Integrated Health Care

Debate between Stephen Dorrell and Anne Milton

Wednesday 2nd June 2010 Commons Chamber

[Anne Milton]

I thank my hon. Friend for that intervention. As the new Minister in this post, I am hesitant to commit to things that I feel might be above my pay grade.

[Mr Stephen Dorrell (Charnwood) (Con)]

Quite right.

[Anne Milton]

I think that I am quite right about that, because that sort of thing is, in general, a career-limiting move. I think that what my hon. Friend the Member for Bosworth is saying, what his concern is and why he feels that the picture is rather bleak is that he has encountered minds that are closed to alternative therapies. That will not be solved by the Government issuing directives, because a number of issues need to be considered, one of which is the training of doctors and those in other professions allied to health care. Our move towards GPs having more power and control, and towards their having the ability to commission services, will, in itself, loosen the ties on how they think about where the best treatment will be found.

I am sure that my hon. Friend will be pleased that acupuncture is used widely in pain clinics and even in some maternity services, and that the Department of Health continues to fund research into new treatments, through the National Institute for Health Research, and to award funding for studies into the efficacy and value of complementary and alternative medicines. The National Institute for Health and Clinical Excellence has already published guidance that refers to complementary therapies—for example, those relating to lower back pain, multiple sclerosis, antenatal and palliative care. Our approach to all treatments, be they complementary, alternative or mainstream, is the same. Treatments must be supported by robust evidence, and they must meet safety, quality, clinical and cost-effectiveness criteria. If they are then called for by clinicians on the ground, they should be, can be and will be used in the NHS.

Question put and agreed to.