Oral Answers to Questions

Debate between Steve Brine and Vicky Ford

Tuesday 24th July 2018 Commons Chamber

[Steve Brine]

The truth is that we work together. In July 2017, the Government published a comprehensive new drugs strategy, setting out what we think is a balanced approach that brings together the police, health, and community and global partners to tackle the illicit drugs trade, and to protect the most vulnerable in our societies who are struggling with drug dependency and help them to recover and turn their lives around. I know the hon. Gentleman takes a very different view, but that is our approach.

[Vicky Ford (Chelmsford) (Con)]

My nine-year-old constituent is currently having up to 400 epileptic seizures every week, and his family believe that medicinal cannabis may be beneficial. Will my hon. Friend update the House on what progress is being made regarding the use of medicinal cannabis for epilepsy sufferers?

[Steve Brine]

Obviously, our thoughts are with my hon. Friend’s constituent. A two-part review is going on. In the first part, the chief medical adviser considered the evidence available for the medicinal and therapeutic benefits of cannabis-based medicinal products, and found conclusive evidence of the benefits of those products. Part 2, which will be led by the Advisory Council on the Misuse of Drugs, will provide an assessment, based on the balance of harm and public need, of whether we need to do anything regarding the misuse of drugs regulations. While the review is under way, we have established, as an interim measure, the expert panel of clinicians to advise Ministers on any licence applications from senior clinicians, which helped Alfie Dingley, for example.

Phenylketonuria: Treatment and Support

Debate between Steve Brine and Vicky Ford

Tuesday 26th June 2018 Westminster Hall

[Steve Brine]

I was going to come on to talk about Kuvan; obviously, I stopped to listen to the hon. Lady’s intervention. No, I will not personally support an individual request. That would not be appropriate for a Minister at the Dispatch Box. That is not how our system works, but if she wishes to write to me with the specific example then of course I will see that she gets a reply. That should be handled through the right processes. I know that the processes for individual funding request applications are sometimes torturous, and I am sure that we could do them better.

Let us touch on Kuvan, which everybody has raised. It is one treatment option that has been found to lower blood phenylalanine levels in some patients with mild or moderate PKU. We know that the drug is effective in a small number of patients, depending on their genetic make-up, and is more likely to benefit those with milder forms of the condition. If patients respond to treatment, it is likely that they will still need to continue with some form of dietary restrictions—everyone understands that.

As we have heard, Kuvan is not currently routinely commissioned for use in children and adults. That is due to the lack of evidence of its effectiveness on nutritional status and cognitive development at the time the policy was developed in 2015. NHS England does, however, have a commissioning policy for PKU patients with the most urgent clinical need—namely, pregnant women, as we have heard.

[Vicky Ford]

Will the Minister give way?

[Steve Brine]

No, I will not. Although the decision taken by NHS England was not to commission Kuvan routinely, the system has the flexibility to review that decision if new evidence emerges. As the House heard during the debate in March, NHS England received a preliminary policy proposal for the use of Kuvan in the management of PKU for adults and children, because new evidence has now been published to support its use. Kuvan was subsequently referred to the National Institute for Health and Care Excellence for assessment through its topic selection process—the process through which NICE prioritises topics for appraisal in its technology appraisal or highly specialised technology programme.

The NICE process is important. It is independent of Ministers and provides a standardised, governed procedure to ensure that NICE addresses topics that are important to the patient population, carers, professionals and commissioners and, similarly, helps to make the best use of NHS resources. To update the House on progress, Kuvan has progressed through the first stage of the topic selection, and NICE is currently considering whether the drug should proceed to the draft scope creation stage. We are expecting that decision to be taken in the autumn. I will press NICE, along with the relevant Minister in the Department—the Under-Secretary who sits in the other place—to bring that to a conclusion as swiftly as possible.

People have asked today for me to personally get involved in access to Kuvan. NICE’s process is important and sits independently of Ministers. It would be a very strange situation if Ministers were able to sit in the Department of Health and, like a Roman emperor, give a thumbs up or thumbs down. I do not think that any Minister in this Government or previous Governments would want to be in that inappropriate position. As I said, we expect the decision to be taken in the autumn and we will press for that to be brought to a conclusion as soon as possible.

I will give the hon. Member for Blaydon time to wind up the debate, but let me say first that there are other promising treatments on the horizon. NICE is currently considering pegvaliase, an enzyme substitution therapy indicated for adults, through its topic selection process, and recently consulted stakeholders on its suitability for the technology appraisal. I can update the House that a scoping workshop on this topic is scheduled to take place tomorrow, 27 June.

Finally, my hon. Friend the Member for Chelmsford said that there had not been a response on BioMarin. She mentioned that point to me last night, and I am worried to hear it. As I said, Kuvan is currently going through the independent NICE assessment. If the topic goes ahead, there will be many opportunities for BioMarin to engage in commercial discussions, as per NICE’s usual process. BioMarin and NHS England are already in discussions about a number of other drugs, so it has the opportunity to raise the issue. However, it seems to me that NHS England could at least communicate better, because no answer sounds like a bad answer. I will take that away from the debate and ensure that it happens ASAP.

I know you want me to stop, Mr Robertson, and let the hon. Member for Blaydon close the debate, so I will do that.

Oral Answers to Questions

Debate between Steve Brine and Vicky Ford

Tuesday 19th June 2018 Commons Chamber

[Vicky Ford (Chelmsford) (Con)]

Stroke is the fourth largest single cause of death in Britain. What action are the Government taking to prevent stroke and to raise awareness? And will the Minister meet me to discuss my GP surgery at Sutherland Lodge?

[Steve Brine]

Two for the price of one. Up to 70% of strokes are preventable if hypertension, atrial fibrillation, diabetes, cholesterol and other lifestyle factors are detected and managed earlier. The current national stroke strategy came to an end last year, so we are working closely with NHS England and the Stroke Association on a new national plan, which I hope to publish this summer.

Southend Hospital

Debate between Steve Brine and Vicky Ford

Thursday 6th July 2017 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

I very much enjoyed the speech by my hon. Friend the Member for Southend West (Sir David Amess). I congratulate him on securing this debate and commend the fire in his belly that always shines through when he speaks in this House, or anywhere else, on behalf of his constituents. They are lucky to have him. I congratulate him on his re-election once again last month.

It is a strange that there is nobody in front of me and everybody I am talking to is behind me, but such is the layout of the House of Commons—and I am of course talking to you, Madam Deputy Speaker.

I understood before I came into the Chamber, and I certainly understand now, that there is significant local concern about the future of the A&E at Southend University Hospital NHS Foundation Trust. My understanding is that Southend A&E will continue to provide substantial emergency services 24 hours a day, 7 days a week, and any change—I underline, any change —to this position would need to meet the four tests of service change. For clarity, let me outline those tests, because they really are the bottom line of any proposed service change in the health service in England. First, proposed service changes must have support from commissioners; secondly, they must be based on clinical evidence; thirdly, they must be able to demonstrate public engagement; and fourthly, they must consider patient choice. An additional NHS England guidance has been added—that proposed service reconfigurations should be tested for their impact on overall bed numbers in the area, and the impact thereof on safety. It is important to set that out very clearly.

The work of the success regime has now fed into the Mid and South Essex success regime sustainability and transformation plan.

[Vicky Ford (Chelmsford) (Con)]

I would like to introduce Broomfield hospital in Chelmsford into the discussion as one of the hospitals in the mid-Essex area along with the three in Southend and those in Basildon. I congratulate my hon. Friend the Member for Southend West (Sir David Amess) on bringing so much experience to this debate. Broomfield is deeply loved. It serves our newest city. We too need our 24-hour consultant-led A&E. NHS England made it clear to me on Monday that it is not only 24-hour, but consultant-led. Can the Minister confirm that? Can he also confirm that any decisions made will put patient safety first? The future of our NHS relies on first-class training and innovation in Chelmsford. As part of the mid-Essex area, we have the country’s first new medical centre. Will the Minister confirm that he supports that medical centre?

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. Lady’s question is slightly tangential to the subject of the debate, but I appreciate that she has made a connection. The Minister might be able to make the connection between the subject of the debate and her question, but I know that he will concentrate on the subject of the debate introduced by the hon. Member for Southend West (Sir David Amess).