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The Minister of State, Department of Health (Mr. John Denham): Our records show that we have received 114 written representations from Members of Parliament, patients' groups and the public about the prescribing and funding of beta interferon since 1 January this year.
Mr. Bercow: I am grateful to the Minister for that reply. Given that Miss Caroline Cripps and Mr. Marc Smith--two brave young constituents of mine who suffer from the relapsing-remitting form of multiple sclerosis--were recommended for treatment by beta interferon by their respective consultant neurologists in June and
Mr. Denham: I am aware that Buckinghamshire health authority has given the go-ahead for more patients to be treated with the drug, but the issue the hon. Gentleman raises is nevertheless an important one. There is wide variation in prescribing practice, although that, as often as not, reflects clinicians' differing views on the clinical benefits and cost-effectiveness of the drug. We have said that we are likely to ask NICE to prepare guidance on the use of beta interferon for both the relapsing-remitting and secondary progressive forms of the disease; but given that NICE came into existence only on 1 April, I do not believe that I can give the hon. Gentleman an assurance that it will be possible for it to report before the summer recess.
Mr. Kevin Barron (Rother Valley): Will we have some national service framework for beta interferon so that we may get rid of the rationing mess that we inherited from the previous Government and direct regional health authorities to spend money in this area of intervention?
Mr. Denham: We have not said that there will be a national service framework in relation to multiple sclerosis, but we want the National Institute for Clinical Excellence to provide authoritative guidance on the clinical benefits and cost-effectiveness of different treatments and pharmaceuticals. The issuing of such guidance will ensure greater consistency in practice from one part of the country to another. We inherited quite unacceptable variations in practice, and we are determined to tackle that problem.
Mr. Philip Hammond (Runnymede and Weybridge): The Minister will know that the Minister for Public Health has said in the House that there is no rationing in the national health service. However, the chairman of the National Institute for Clinical Excellence has stated that that institute may have to recommend against availability on the national health service of clinically effective drugs such as beta interferon because of limited resources. Would Health Ministers accept such a recommendation from NICE? If that is not rationing, what is?
Mr. Denham: I do not know why the hon. Gentleman refers persistently to the comments of my right hon. Friend the Minister for Public Health, because I have said precisely the same thing on several occasions. Priority setting has been a part of every health system in the world, and I believe that the national health service is fairer and more equitable than all of those systems. The hon. Gentleman should be aware that we know what he and his right hon. and hon. Friends are up to: they are seeking to use this issue to undermine public confidence in the national health service in order to promote their own agenda of private health care.
The Minister of State, Department of Health (Mr. John Denham): The United Kingdom benefits from a competitive generic market in which prices fluctuate naturally in response to a wide range of factors. There have been reports of increases in the prices of some products since the new year, but I do not think it would be reasonable to attempt to define a trend based on the short period since 1 January 1999.
Mr. Burden: I thank my hon. Friend for that reply. He will be aware of the on-going concern about the effectiveness or otherwise of the pharmaceutical price regulation scheme--indeed, that issue is partly addressed in the new Health Bill. Is the Minister aware of informal research conducted in Birmingham into 12 commonly prescribed drugs, which revealed that at least some have increased in price by 50 per cent. or 60 per cent. since 1 January this year? In one case, the price increased by 114 per cent. As I have said, that is informal research, but does it not suggest that consistent national research should be conducted so that we may discover what is going on in this area and be assured that the NHS, and therefore the patients, are not being ripped off by at least some pharmaceutical companies?
Mr. Denham: I assure my hon. Friend that we always monitor carefully the movements in pharmaceutical prices, and will continue to do so. I shall certainly examine the reported increases in the prices of some generic products since the beginning of the year.
By and large, generic prices are kept in check by the effects of competition and the reimbursement system for dispensing contractors. There were an unusually large number of shortages in the supply of certain medicines earlier this year. Those shortages appear to have been temporary--many have been resolved--but they may have been reflected in the price increases. The key point is my assurance to my hon. Friend and the House that we will monitor the situation very carefully to identify whether any other factors are at work.
The Minister of State, Department of Health (Mr. John Denham): Edgware community hospital forms an integral part of the health service in that part of London. All local national health service organisations are committed to ensuring that the level of out-patient and day surgery services at the hospital is appropriate and that those services are effective in meeting the needs of local people.
Mr. Denham: I want to reassure my hon. Friend. It is true that some services were transferred from Edgware hospital in what was always regarded as a short-term move. Currently, 60,000 out-patient attendances are reported at Edgware community hospital, but I can assure my hon. Friend that local NHS trusts are working hard, with the full support of the health authority and of primary care groups, to ensure that sessions in general surgery, urology, gynaecology and orthopaedics are reintroduced to the hospital.
Sir Sydney Chapman (Chipping Barnet): What changes have there been to the accident services at Edgware other than those that were planned by the previous Government? Is not the truth of the matter that the only change that has been made is to call it something other than a minor accident treatment centre, which has so confused people who have what they think are serious injuries that they go to Edgware instead of Barnet?
Mr. Denham: It was the Government in which the hon. Gentleman served who closed the accident and emergency department. Since we came to office, we have sought to define clearly a new and positive role for Edgware community hospital. I have mentioned the additional services that local trusts are seeking to develop. The first phase of the redevelopment of the hospital has already been completed, at a capital cost of £11 million, and I understand that a full business case for phase 2 is due for submission to the National Health Service Executive shortly. We have therefore given significant backing to the future of the Edgware hospital.
Mr. Tony McNulty (Harrow, East): I am grateful to my hon. Friend for confirming that the Tories, not the present Government, shut the A and E at Edgware, on 1 April 1997. Can he confirm that the services that the urgent treatment centre will provide will represent a significant advance on what went before, not least in telemedicine, given that it has all been taken over by Central Middlesex hospital trust--not Wellhouse trust, which was a sham and a disaster from day one?
Mr. Denham: I heard the word sham, but not what it referred to; that is why it is difficult for me to answer the question fully. However, my hon. Friend can be assured of our genuine commitment to the future development of high-quality services at Edgware community hospital.