GOVERNMENT AND EU
385. The Government and European Commission see the
maintenance of a large and profitable pharmaceutical industry
as vital. There are additional measures that the Government could
take to encourage it. We have already made recommendations to
facilitate clinical trials in the UK. It is also important that
it ensures that there are sufficient staff with the right variety
of skills needed by the pharmaceutical industry. There is a shortage
of chemists, yet some university chemistry departments are closing
or under pressure to close. The
Government should look at the levels and range of expertise required
by the pharmaceutical industry and, with universities, take action
to ensure that appropriate numbers and quality of staff are trained.
386. The Government has had considerable success
in maintaining a profitable and effective pharmaceutical industry.
However, it should also give equal priority to health. This it
has not done. Drugs have been too readily licensed and prescribed
and iatrogenic disease is an increasing problem. The Government
has also done little to curb the increasing 'medicalisation' of
society. Indeed it may have encouraged it. There is not and cannot
be a pill for every difficulty we face. The prospect of ever more
sophisticated drug development implies some urgent need to define
the limits of medical intervention.
387. We know too little about the optimal uses and
effects of existing drugs and in-depth investigation of existing
(off-patent) treatments is uncommon. Considering, for example,
the myriad uses of aspirin, many of which were discovered long
after the drug was originally available, greater investigation
of existing medicines is a worthwhile venture. There is also too
little independent research into the use of drugs compared to
non-drug approaches. Neither the illness caused by drugs nor the
health effects of medicalisation
have been adequately investigated.
388. Pharmaceutical companies cannot be expected
to undertake in-depth research into these areas. In the absence
of other sources of funding this research must be financed by
the Government. We recommend
that the Government fund:
- A multi-disciplinary
investigation of existing medicines, combinations of medicines
and medicines use where there is a reluctance of the industry
to fund such research;
- Research into the adverse health
effects of medicalisation;
- Trials of non-drug approaches
recommend that the extent, cost and implications of illness resulting
from the use of medicines be systematically investigated by the
Department of Health in conjunction with the MHRA.
390. There are a number of specific measures which
may help to focus on health priorities. The World Health Organization
has recommended that all countries adopt a National Drugs Policy
to encourage the availability of medicines to all types of patients,
the safety and efficacy of these medicines and their rational
use. We recommend that the
Government adopt a National Drugs Policy to encourage the availability
of medicines to all types of patients, the safety and efficacy
of these medicines and their rational use and to ensure that medicines
are compared to non-drug approaches.
391. The NHS, despite its size, has no policy on
the evaluation of drugs in treatment relative to non-pharmacological
approaches. We recommend
that the NHS adopt a policy regarding the role of drug treatment
in relation to non-drug treatment, emphasising the importance
of both approaches.
392. During this long inquiry we have become concerned
that there is a fundamental weakness in the Government's dealings
with the pharmaceutical industry: that is the Department of Health's
dual role in promoting health and acting as 'sponsor' of the industry.
These roles have not proved compatible. Health and trade priorities
are not always identical and their combination leads to a lack
of clarity of focus and commitment to health outcomes. We need
a Secretary of State for Health who is not saddled with dual responsibilities,
who is not a 'cross-dresser' but who puts health priorities first.
We recommend that responsibility
for representing the interests of the pharmaceutical industry
should move into the remit of the Department of Trade and Industry
to enable the Department of Health to concentrate solely on medicines
regulation and the promotion of health.