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Mr. Lansley: Let us give credit where it is due. The World Health Organisation has instituted the global campaign for microbicides and the British Government have allocated £16 million in support between 2003 and 2006.
The Government somehow have to balance the needs of patient safety and the industry's ability not only to survive, but to survive in a reasonably profitable form. The lesson that we learned in Australia from New Zealand was that the controls were so firm that the pharmaceutical industry had virtually moved out of that country.
Mr. Charles Walker (Broxbourne) (Con): I am grateful for the opportunity to speak in this important debate. I thought that I would need to have my boxing gloves on, metaphorically speaking, to take on the hon. Member for Newport, West (Paul Flynn), but as I listened to his excellent speech, I found that I agreed with much of it.
I must first declare an interest in that Merck Sharp and Dohme is based in my constituency. I am pleased to have that company there, it is a good employer and I hope that it continues to operate out of the UK as well as other countries. The pharmaceutical industry plays an important role in the UK. It employs many hundreds of my constituents and across the country it employs many tens of thousands of people. It spends a vast amount of money on researchit should be remembered that only one or two in 100 drugs on the drawing board reach fruition. Of course, pharmaceutical companies need to make returns on those one or two to fund future research. I have no objection, therefore, to pharmaceutical companies marketing more aggressively than perhaps the hon. Gentleman would like to see them do, or to their making a profit.
Before I became a Member of Parliament, I worked in health care as a PR person. That is why I listened with great interest to the hon. Gentleman. At the tender age of 27, I was responsible for promoting certain diseases, one of which was osteoporosis, and 11 years ago, it probably needed promoting. The system works as follows. Some motivated and passionate charities are connected with certain diseases, and they have very little or no money. In such cases, generous pharmaceutical companies with a treatment for one of those diseases come along and sponsor some of the charities' activities. As I said, we needed to promote osteoporosis because so many people, especially women, were afflicted with it, and politicianswe had a Conservative Government thendid not take it seriously or see it as a priority.
I have to say that I now regret my involvement in promoting some diseases, especially depression. While some people do suffer from serious depression and
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SSRIs are useful drugs for treating it, I am concerned that too many doctors, for whatever reason, prescribe SSRIs without taking the time to understand the causes of their patients' problems. I understand, from talking to many of the same charities to which the hon. Gentleman has talked, that sometimes a patient gets less than five minutes and to get them out of the door they are prescribed SSRIs, which can have serious side effects for some people and cause great discomfort. They can also be very difficult to come off. I hope that as a result of this debate the Minister will take away the concerns about SSRIs. Perhaps we need a process of education for GPs to ensure that they take more time to understand the root causes of people's problems before prescribing a pharmaceutical solution.
I am glad that the ABPI recognises some of the concerns about support for patient groups and paid-for doctors writing in support of drug companies' solutions to an illness. Coming from a PR background, I am aware that there was always a difference between an advertorial and an editorial, and perhaps we have seen editorials that should have been branded as advertorials. There should be greater transparency. Pharmaceutical companies should make it clear which groups they support, be they academic or charities, and when a doctor or professional writing in support of a treatment is in receipt of funding from the company producing that treatment, that should be made clear.
This was intended to be a short speech, so I shall conclude by agreeing with the hon. Member for Bolton, South-East (Dr. Iddon) on the danger of counterfeit medicine and internet pharmacy, 99.99 per cent. of which is unregulated and operated from places such as Tonga in the Pacific. Drugs that are sold back to the UK may be as harmless as sugar but, for example, if a woman were to take Propetia, it could have severe, possibly even life-threatening, implications for her health. I hope that I can join the hon. Gentleman, perhaps in a future debate in Westminster Hall, to explore that problem, which was not covered by the report.
Adam Afriyie (Windsor) (Con): It is a pleasure to participate in this debate. We should be thankful to the pharmaceutical industry, which, over the past couple of hundred years, has introduced cures and treatments for ailments that affect many people. We should be thankful to the Select Committee for its excellent report and recommendations. We should also be thankful to Parliament for establishing the National Institute for Health and Clinical Excellence, which does good work in regulating what comes on to the market as an acceptable treatment.
The Select Committee report and the Government response are concerned with life-and-death issues, particularly with regard to the speed with which treatments reach the market. I should like to raise three brief concerns, the first of which is the funding available to NICE. There was a clear recommendation that its
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funding should be increased. The Government response was fairly clear: they would look at the matter in the round in the future. It is slightly more urgent than that. If we expect NICE to do its work, the fact that so many drugs are coming on to the market and so many clinical trials are taking place mean that its funding needs to be increased, and soon. The £3.5 million that was withdrawn resulted almost directly in one of the appraisal panels being closed. Perhaps the Minister can say a few words about that in his response.
My second concern relates to the recommendation from the Secretary of State that Herceptin be fast-tracked and that PCTs should begin allowing women with early stage breast cancer to use the treatment. I welcome that decisionby all accounts, the drug is effectivebut it raises concerns and questions. On what basis should a Secretary of State for Health intervene in the process? On what basis should the Secretary of State select a drug or treatment for fast-tracking? Surely there should be overt, rational and robust guidelines that are open for everyone to see, so that any decision is not made as a result of public pressure or, dare I suggest, PR pressure from the pharmaceutical industry. Although the decision raises some questions, I was delighted with the recommendation.
My third concern is that medicines reach the market on the basis of robust evidence. I said earlier that if NICE is unable to see all of the evidence, clinical trials and data on a treatment, it is not necessarily in a position to make a sound judgment. If it sees only the published reports of clinical trials, it is not seeing the full picture and it cannot necessarily make a fully informed judgment.
The House and the Government have a duty to protect people from unsafe medicines, and NICE does a good job in the circumstances. However, I urge the Minister to take a good look at, first, the guidelines for NICE to ensure that it can consider all the evidence involved; secondly, the basis on which the Secretary of State for Health can circumvent or intervene in the process of drug prescription; and thirdly, the funding available to NICE, so that, as patients and the pharmaceutical industry make more demands in the future and the evidence becomes clear that certain medicines look useful, those medicines can be processed, examined and reviewed very quickly by an excellent institute.
Mr. Andrew Lansley (South Cambridgeshire) (Con): This has been a very good debate, and I am delighted to have had the opportunity both to listen and to respond to it. I apologise, Madam Deputy Speaker: I am part of a Standing Committee upstairs, so I had to depart once and was unable to hear all that my hon. Friend the Member for Southend, West (Mr. Amess) had to say.
I join other hon. Members in congratulating the Health Committee on its work. Its report has already proved to be a very important; it has led to action by the Government and the pharmaceutical industry. I am sure that the Health Committee will help to guide and press for action in the future. As the Chairman of the Select Committee said, it will return to the issue and rightly so, and it would be very useful if it did precisely that in one or two instances that I might mention during my remarks.
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I want to say a special word of thanks to David Hinchliffe, the former Member for Wakefield, who was Chairman of the Health Committee when I was a member of it in the early part of the 1997 to 2001 Parliament. He did a remarkable job. Many people across the NHS very much valued his work, and the right hon. Member for Rother Valley (Mr. Barron) will be a distinguished and equally competent successor.
The right hon. Gentleman was quite right to point to the importance of safety, which is a central issue. I was surprised, particularly during the discussion of Vioxx, that there was little mention of the subsequent actions by the pharmaceutical industry to promote the publication of all clinical trial data. That is an important matter. The Select Committee considered the origin of the problems with Vioxx, and they were substantially related to the failure of transparency on clinical trial data, as well as, arguably, the company responses. If we are to deal with those problems, we require not only ethical responses on the part of pharmaceutical companies, but the sort of transparency that allows early indications of effectiveness to be challenged by others using the data.
The hon. Member for Newport, West (Paul Flynn) rightly illustrated the fact that it is terribly important to use the data properly. However, if he is right and there have been instances where conclusions reported in medical journals are not consistent with the datathat would be entirely wrongit is absolutely essential that other researchers have access to the data in a form that allows them to engage in the scientific method and to challenge the conclusion that others have reached. That is what science is about. We applaud scientists for what they are doing, so we should give them the maximum opportunity to use their method in that way.
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