The Minister of State, Department of Health (Jane Kennedy): The National Institute for Health and Clinical Excellence has not yet published a time scale for the completion of its appraisal of Velcade. The Department of Health is considering proposals from NICE to speed up significantly the appraisal process for important new drugs and health technologies.
Mr. Keetch: Is the Minister aware that, on 20 July, the Secretary of State announced that Velcade would be fast-tracked for NICE assessment? However, since then 1,000 more patients have been diagnosed with myeloma in this country. Is the Minister aware that Velcade has already been approved in Scotland and Wales? Consequently, Welsh patients being treated in Hereford county hospital automatically receive the drug, but Herefordshire patients being treated in the same hospital do not. I am delighted that Welsh patients are receiving it, but will the Minister ensure that it becomes available to my constituents as soon as possible so that they can be treated with it in their own hospital?
Jane Kennedy: I am grateful to the hon. Gentleman for drawing those specific details to my attention. I agree that the process for appraising important new drugs has become too lengthy. That point has been made not only by him but by a number of other hon. Members in the House. We are working with NICE on plans to speed up the process by which new drugs and health technologies are appraised, while ensuring that the appraisal process remains robust and credible. It is unacceptable for primary care trusts and other health bodies to use a lack of NICE guidance as an excuse for refusing to consider evidence in reaching decisions on whether to make new treatments available on the NHS.
Mr. Robert Flello (Stoke-on-Trent, South) (Lab): Can my right hon. Friend update the House on the progress of Herceptin, a drug that is very much on the mind of my constituents and those in the wider north Staffordshire area?
Yes, the House will be aware that the South West Peninsula health authority recently announced that it would allow treatment, on the condition that the patient is supported by the patient's
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clinician and that the patient is willing to receive the drug. There is nothing stopping other health authorities prescribing Herceptin if they wish. Patients can be prescribed an unlicensed drug, but this should be the exception, not the rule, because the licensing process is there to protect patient safety. It is a very important process. We should take care not to undermine it.
David Tredinnick (Bosworth) (Con): Is the right hon. Lady aware that it is not just Velcade that the National Institute for Health and Clinical Excellence is being asked to assess? Has she looked at Christopher Smallwood's report, which recommends that NICE consider the cost-effectiveness of complementary and alternative medicine because he has established that there are various gaps in the provision
Mrs. Sharon Hodgson (Gateshead, East and Washington, West) (Lab): I understand that the initial role of NICE was to put a stop to the postcode lottery in health care. Will my right hon. Friend clarify the current role of NICE in that regard, bearing in mind the extended time that it takes to approve some drugs that have possible life-saving benefits? The postcode lottery is alive and well, as we have heard, because some health authorities and local trusts prescribe drugs such as Herceptin before they have been approved for purpose while others do not.
Jane Kennedy: Guidance from NICE has benefited thousands of patients and it is highly regarded internationally for its work on clinical and cost-effectiveness. Indeed, the World Health Organisation has commended its methodologies. While we have some of the fastest falling cancer death rates in Europe, I accept that there is more to do to improve the uptake of new medicines and treatments by the NHS, which is precisely why we are working with NICE to review the procedures.
The Minister of State, Department of Health (Jane Kennedy): The intention is that the "Better Healthcare Closer to Home" project will modernise and improve local health services in Merton, Sutton and mid-Surrey, and the proposal is with my right hon. Friend the Secretary of State for decision. This is a complex decision, and it is taking time to review all the documentation and information that have been supplied.
The Minister may be aware that under the "Better Healthcare Closer to Home" proposals, the primary care trusts were to run local care hospitals. Following Sir Nigel Crisp's announcement, clearly that is no longer the case. Can the Minister say who will run those local care hospitalsperhaps a private company,
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a consortium of general practitioners or even the local authority? Can she also say what extra action she can take to reassure PCT employees who are
Jane Kennedy: We are talking about a £350 million investment in new and refurbished hospitals that will benefit the constituents of the hon. Member for Carshalton and Wallington (Tom Brake) with better, more modern health care services. His point about PCTs has already been answered by my right hon. Friend the Secretary of State. There is nothing I can say to add to it. He must listen to the answers he is given.
It is interesting to hear the hon. Gentleman make this point, because decentralisation and the offer of additional charges to be levied for higher quality non-clinical services, paid by those willing to pay them, are precisely the policies on which his party fought the last election.
Mr. Graham Stuart (Beverley and Holderness) (Con): Health care closer to home is hardly being delivered by cuts and closures of community hospitals up and down this country. My constituents in Hornsea and Withernsea are furious with this Government. What is the Minister going to do about reversing those cuts in beds and services at our community hospitals so that we can have care closer to home?
Jane Kennedy: It is a pleasure to debate with the hon. Gentleman exactly where and how to invest £350 million in new hospitals. When his party was in government, we would have been holding flag days to provide them.
The Minister of State, Department of Health (Jane Kennedy): The Department is committed to reducing unnecessary spending on administration and releasing the resources saved to front-line care. Those savings are part of planned efficiency savings of £6.5 billion by 200708, which are being recycled into local services.
Mr. Hendrick: My right hon. Friend will be aware that the Lancashire Teaching Hospitals NHS Trust, which includes the Royal Preston hospital in my constituency, has gone from two-star to three-star status, has now acquired foundation status and has hit nine out of nine of its key targets. Can she assure me that cuts in administration and moving resources to front-line services will make those services even better than they already are?
I am grateful to my hon. Friend for pointing out the real success and improvements taking place in front-line services. I hope that I can give him the assurance that he seeks.
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Mr. Peter Lilley (Hitchin and Harpenden) (Con): On the notional transfer of resources to front-line services, can the Minister tell us how many primary care trusts, as a result of the new centrally imposed GP contract, will increase payments to GPs in the coming year by between £20,000 and £25,000 each compared with last year, and how many consultants, as a result of the new consultant contract, will earn more than £20,000 more this year than last year? Was that the intention of either contract and is that the best use of money in the national health service?
Jane Kennedy: The right hon. Gentleman asks a detailed question, and with my mental arithmetic not being as good as it should be, I will get back to him on the detail. His general point, however, is important. We decided to agree those new contracts and pay the salaries that go with them precisely because we needed to retain really good people in the health service. That is what the whole process was about.
Mr. Brian Jenkins (Tamworth) (Lab): Will my right hon. Friend explain to me and the people of Staffordshire how the performance of probably the finest ambulance service in Europe, the Staffordshire ambulance service, will be improved by merging it with any other ambulance service? Will she guarantee that any merger will take place only if both partners are at the same level of performance?
Jane Kennedy: We want the very high quality of service from which my hon. Friend's constituents in Staffordshire benefit to be the experience of everyone in England and no changes will take place without the fullest possible consultation.
Tim Loughton (East Worthing and Shoreham) (Con): Last year's Secretary of State ordered a review of the Department's arm's length bodies. Since then, the number of staff in those bodies has fallen by just 2 per cent. It has cost £32 million to close some of those organisations and £4.7 million to establish some new ones, added to which the administrative costs of running her Department are now running at £296 million, and trust chief executives estimate that they spend at least a day and a half a week just providing information to the Government and strategic health authorities. Is it therefore right that the Government should demand 15 per cent. efficiency cuts by PCTs, leading to bigger deficits and shrinking front-line services, when she and her right hon. and hon. Friends have signally failed to get a grip on the running costs of her Department?
Yes, it is right that we should seek efficiency savings. An organisation the size of NHS, which treats millions of patients a year, must have effective management as well as administrative and clerical staff to take away that burden. No one wants to see nurses and doctors wasting valuable time on training or being tied up with administration instead of being out on the wards delivering patient care. We need to stop using NHS managers and support staff as scapegoats, as Conservative Members often do. We need to back those who are working flat out to support the NHS.
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