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Mrs. Robinson: Would the Minister accept that if someone is diagnosed with a life-threatening illness, and despite, possibly, the downside of using a drug, if that drug gives people hope they will ask to be the guinea pigs, as might be said; and that we cannot fault people for wanting something that possibly offers a higher percentage positive outcome than a negative one?

Mr. Woodward: Of course we could not fault anybody who is facing a life-threatening illness for asking for a new treatment. It follows also that we have a responsibility to ensure that because a patient asks for something, they are prescribed something that will make them better. Further, it follows that if we are aware of serious side effects that may occur, we have a responsibility to make them aware of serious side effects.

It is worth remembering that in Northern Ireland we have a very good record of dealing with breast cancer. Obviously, no doctor would want to prescribe a drug for a patient that may lead that patient to an even worse condition as a result of the application of that drug. I am reminding the hon. Lady that when we have campaigns for the prescription of drugs, often the downside of prescribing the drugs is forgotten. There is a responsibility in media campaigns and in political campaigns, when we are trying to get the application of certain drugs, to be responsible in telling patients, "Yes, let us all hope that this is a wonder drug." I think that every Member of this place would want to recognise that if Herceptin holds out that hope for women in the early stages of breast cancer, it would indeed be a wonder drug if it turned out to be everything that everyone hopes of it. However, we are not yet sure of that. It is extremely important, particularly important for very vulnerable people who are facing life-threatening illnesses, that expectations are not raised to a point that we cannot at this stage fulfil.

I am committed to improving access to specialist medicines that offer the potential for significant improvement in patient care. In recent years we have made some progress, although we still have further to go.

For example, the number of people receiving anti-TNF treatment for severe inflammatory arthritis has doubled between April 2004 and April 2005. In April, 178 people were on these drugs. There are now 361 on them. This represents an additional investment in this one area alone of about £2 million.

There has also been a significant increase in the number of people with multiple sclerosis receiving disease-modifying therapies such as beta interferon. The number of people receiving these drugs has increased from 442 in April 2003 to 577 at present. This represents about 17 per cent. of people with MS in Northern Ireland, and compares favourably with other areas of the UK. New drugs have also been made available to combat hepatitis C, HIV, inherited genetic disorders and cancer.

Not for one moment should I or anybody in my Department be complacent. Despite the increased number of patients receiving specialist medicines, the hon. Lady rightly draws our interest to the numbers of people waiting for these drugs. I share with her the concern for the number of patients with severe inflammatory arthritis waiting for anti-TNF treatment, and the numbers waiting for treatment for MS. As the hon. Lady said, 146 patients
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are currently waiting to begin disease-modifying treatment for MS. Some of these patients have been waiting for more than 12 months.

Mr. Bone: Last week, the Secretary of State for Health led us to believe that nobody in the UK had to wait more than six months for treatment. That needs to be corrected because, to me, that is fundamentally untrue.

Mr. Woodward: Unfortunately, I cannot answer for my right hon. Friend. I am the Minister with responsibility for health in Northern Ireland. Undoubtedly we will draw the hon. Gentleman's remarks to the attention of my right hon. Friend the Secretary of State for Health.

Four hundred and fifty-six patients are currently waiting to begin anti-TNF treatment for severe inflammatory arthritis. Some have been waiting for more than two years, in pain and frustrated that they cannot access the treatment they need. I agree with all hon. Members that that is intolerable. Behind every waiting list there are desperate personal stories of patients experiencing great difficulty because of their condition.

We intend to improve access to these drugs, which undoubtedly have the potential to transform patients' lives. We will not be able to turn the current position around overnight. I have, however, taken initial steps to bring about real improvements. First, an additional £5 million has already been invested to improve access to specialist medicines in Northern Ireland in the current year.

Secondly, I expect to be able to invest a further £9 million in 2006–07. That money will be invested to fund new drug treatments and the infrastructure required to administer them. Next year, there will be significant additional investment in anti-TNF drugs, beta interferon for MS, and existing and new specialist medicines for cancer treatment. The additional investment of £9 million will help to reduce waiting lists for specialist treatments and to ensure that patients in Northern Ireland have access to the very latest specialist drugs. But even those investments will not be enough to meet the growing demand for new and existing drugs. Resources and funding will always be an issue. If we want these drugs, the Government have a responsibility to work out how we are going to pay for them.

The hon. Lady is aware that next week I will bring forward my proposals for water charges in Northern Ireland. Although I know that she and her hon. Friends bitterly resist those proposals, it is worth putting it on the record that the money that will come from water charges in Northern Ireland will bring an additional £300 million into the Exchequer over the next three years. We can put that money into essential services in Northern Ireland. I understand that until now the hon. Lady and her hon. Friends have resisted the introduction of water charges. However, it is important that she face up to the fact that when she asks for more money for drugs—I absolutely understand that we have a responsibility to find the money for those drugs and to deal with the waiting lists—we in Northern Ireland have a responsibility, where we can, to find that money from our own resources. That is appropriate if we are to create parity with the rest of England, Wales and Scotland.
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Mr. Donaldson: What assessment has the Minister made of the savings that will accrue from the changes in the governance of health in Northern Ireland outlined in the proposals published this week under the review of public administration? Will he give a commitment that savings that accrue from the structural changes in the health service will be channelled towards extra funding for specialist treatments?

Mr. Woodward: I am grateful to the hon. Gentleman for raising that issue. As I said this week in my statement on reform of the health service in Northern Ireland, the cost of administering the health service and social services in Northern Ireland is some £155 million. We have a population of just over 1.7 million people. That is about the same as Kent, yet Kent has fewer than 10 trusts and we have 19. We have four boards that in effect work as strategic health authorities. I propose to turn the 19 trusts into five plus an ambulance service trust and to get rid of the four boards, which employ 600 people, and replace them with one strategic health authority. Also, four patient councils will be replaced by one patient council.

I hope that at least £15 million—perhaps £30 million—can be found out of the current cost of running health and social services. I have already undertaken that all the money from the savings that are achieved by reforming the health service infrastructure should go into front-line patient services and into doing something about the application of new drugs and the misery that people suffer while waiting for them.

Mrs. Robinson: Although my point is not about drug availability, have the Government made an assessment of the savings that will accrue through our introduction of the no-smoking ban in public places in Northern Ireland? That will have a major effect on all sorts of illnesses that derive from smoking.

Mr. Woodward: We did that when we made the impact assessment. In the long-term, the proposals will save a huge amount of money. Three thousand people a year die from a preventable illness caused by or related to smoking and passive smoking. However, in the short-term, we are unlikely to experience any savings because, regrettably, much of the damage will have already been done to people and the health service should look after them, regardless of whether they should have smoked.

I intend to put money into health promotion campaigns to encourage people to stop smoking and into cessation services to enable people to stop smoking. In the short term, I expect to spend more money on encouraging people to stop smoking than will accrue in savings.

Infrastructure savings can undoubtedly be made given the inefficiency and the waste of the bureaucracy of the current health and social services system. As I said earlier this week, that is not a reflection on the staff—the doctors, nurses, consultants or many people who form part of the secretariat. We have managed to create a
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highly inefficient system in Northern Ireland that is too bureaucratic. We can slim it down and put the £30 million into drugs and patient services.

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