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Mr. Nigel Evans (Ribble Valley) (Con): May I start by wishing everybody a merry Christmas and a happy new year? I thought that I would do my speech backwards just to confuse everybody, and certainly me. I enjoyed, and agreed with every word of, the speech of the hon. Member for East Antrim (Sammy Wilson). There are so many topsy-turvy things here, which is why I started by wishing everybody a merry Christmas. Because of political correctness, people are supposed now to say "happy holiday" and not use the word Christmas. Christmas lights and Christmas trees have been renamed winter lights and winter trees. What a load of rubbish.
I take joy in the fact that I will be singing Christmas carols at the Swan with Two Necks on Thursday with a number of other parishioners at that local pub, having already sung carols last Sunday. Indeed, I will be having Christmas lunch with my family and, like a number of people throughout the country, I will be looking forward to celebrating the birth of Jesus Christ.
I wish everybody good luck for 2006; a number of issues that have been mentioned today will be very important next year. We had a statement on the Hong Kong summit earlier. The hon. Member for East Antrim mentioned Make Poverty History and, at the last election, I was buoyed by the fact that so many people raised that as an issue on which we should do more. People say that charity should begin at home. If so, in my constituency—and, no doubt, in many others—home begins with the world. They see the world as part of their home.
People do not want to sit by idly and watch as parts of our world are ravaged by poverty, HIV/AIDS and deprivation, when things could so easily be altered. I was distressed to hear the Secretary of State for Trade and Industry talking about some of our developed neighbours acting as a block to progress. We have to do more with France and Germany, and we should have a united European front on this issue so that we can negotiate with the United States on an equal basis to do something to alleviate poverty.
I have been to Africa on a number of occasions and have seen for myself the deprivation there. I have also been made chairman of a working party on behalf of the Commonwealth Parliamentary Association dealing with HIV/AIDS. Certainly, Africa is a nightmare as far as that is concerned. Three million people will die next year and, even more distressingly, 5 million others will contract HIV during that period. That is distressing for all of us. We ought to be doing more to ensure not only that antiretroviral drugs are made more readily available to far more people, but that education is provided so people do not contract HIV.
It is not just a question of sub-Saharan Africa; 5.1 million people in India have HIV. Even within this country, the figure has quadrupled in recent years,
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simply because a number of people with HIV have decided to settle in this country. There is not a single country where HIV does not exist and we ought to be doing far more to help to ensure that fewer people contract it. We all know the misery associated with HIV, including the orphans created throughout the world. The economically active people in a society are those who tend to get HIV, so it hits the economy doubly.
I was delighted to hear my right hon. Friend the Member for Penrith and The Border (David Maclean), the former Chief Whip, making his first contribution to the Christmas debate for a long while. He talked about one of my pet subjects: wind turbines and energy generally. Yes, we want far more efficient supplies of energy, and some of us look at the middle east states and worry about the certainty of future supply and the price we will pay for it, but we must not pay lip service to wind power at the expense of far more viable forms of energy. I hope that the Minister will mention the timetable for the Government to say yea or nay to nuclear power. The last thing we need is more dithering. Literally hundreds of wind farms are coming on stream. Wind farm turbines are bigger than Nelson's column, so do we really want such things to litter and pollute our country? The answer has to be no. We must do something about the problem, and I hope that the Minister will say something in response.
Another issue that has motivated me over the past few months is the way that our representation abroad is being diminished. That is happening in Commonwealth countries and in nations that have been friends of the UK for a long time. The Foreign Secretary announced recently that a number of missions were to close—in Vanuatu, Tonga, Kiribati, Paraguay, the Bahamas, Lesotho, Swaziland, Madagascar and East Timor. Each closure is worrying, but the list that I have given is in addition to various other missions that have either closed or been merged.
It is risible to think that we can run our representation in Vanuatu, Tonga and Kiribati from Fiji. We cannot retain our influence on countries when we close our missions: every time we lower the flag, we reduce our influence in the world. However, the vacuum of influence will be filled by other countries, such as China. That country is increasing the number of missions that it has around the world and in Gabon, for example, it has built new schools and a new Parliament building. Closing down our missions will save a few pounds, but the price will be all the influence that is lost.
In addition, this country has made an investment in the work that has been done over many years by high commissioners and ambassadors. All that is being cut away, and I consider that to be a sacrilege. It is ridiculous for this country to pull out of Tonga, for example, given our long association with that country and its royal family. I therefore hope that more consideration will be given to our representation abroad.
The Foreign Secretary says that we are increasing the number of missions in certain countries in the middle east, and that is good, but we are also closing some of our consulates in the US. One reason for having consulates throughout the US, and not just restricting our representation to the embassy in Washington, is that their presence helps many of our constituency businesses to carry out trade. If we want to increase
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trade between the UK and the US, why are our US consulates being closed? In that connection, I remind the House that some consulates in Germany have also been closed.
I hope that the Foreign Office can find another way to maintain representation around the world. Even if any new system might be different from what we are used to, at least some representation would be better than none at all. I hope that the Minister will respond to that point as well.
I shall finish with one more impassioned plea, this time about the NHS in my area. At health questions earlier today, the hon. Member for Pendle (Mr. Prentice) and I asked about the merger of the accident and emergency units at the Burnley general and Queen's Park hospitals. The Minister knows the Ribble Valley area well, so he will be aware that much of it is rural. The availability of hospital facilities in Burnley and Blackburn is important to my constituents. It already takes a long time for people in my area to get to those hospitals, whether they go as patients or visitors.
However, we know that the word "merge" is a euphemism for "cut". The Government do not want to say that a facility will be closed, so they prefer to say that it will be merged. In this case, the accident and emergency departments will be merged at one site—not in Burnley, I suspect, but in Blackburn. The excuse that has been given is that all the experts in the area will be gathered under one roof, but the same argument could be used in connection with all sorts of services that hospitals offer. Any merger or closure of facilities could be explained away by referring to the greater throughput of patients that could be achieved by having all the relevant experts working from one hospital.
I want to ensure that the level of service that we had when I came to Parliament in 1992 is still provided today. I know that the Government have invested more money in the national health service, which is why I scratch my head as to why my local hospitals have bigger debts than they have ever had and are cutting back services. That makes no sense to me, and I hope that the Minister will be able to shine some light on what is going on.
I finish as I started, by wishing all hon. Members, Mr. Speaker, the Deputy Speakers, the Clerks and everyone who works in the Palace of Westminster a very merry Christmas.
4.15 pm
Dr. Julian Lewis (New Forest, East) (Con): Some jobs in politics require an optimistic temperament, and the Deputy Leader of the House is the occupant of one of those jobs today. For large parts of the debate, he has had just himself, with a solitary Whip for company, his party having run out of speakers on the Christmas Adjournment some three hours before its end. That seems a statement of the condition of the modern Labour party, even considering that it won a general election victory earlier this year.
My mind goes back to the happy, but false, dawn of 1997, when Labour swept in with all those new faces, all those bright and shiny people and all those wonderful ideas of modernisation. I remember speaking after perhaps three or four months to a new Labour MP, who is sadly no longer in the House, who had a particular
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interest in defence. I asked whether he would speak in that afternoon's defence debate. "Oh no, Julian," he said, "I can't do that as I would use up my speech allocation." I asked what was his speech allocation, and he said it was four speeches a year. Those were the days, the Deputy Leader of the House must be thinking. Back then, the Whips had to ration their people to four speeches a year; now they are lucky if they can get anyone to keep a debate going.
Another person who is a born optimist is my right hon.—indeed, very gallant—Friend the Member for Penrith and The Border (David Maclean). One would have to have been an optimist to become Chief Whip of the Conservative party in 2001, but he was equal to the task and did it very well. During his speech today, when he talked of his experience with his community hospitals, four of which are under threat, I was irresistibly reminded of what is happening in New Forest, East, in New Forest, West and in Romsey. Five community hospitals are under threat, and we, too, had a 2,000-strong demonstration, the first of its sort in many a long year in our part of the world. The primary care trusts have indeed apparently retreated on their threat to close the hospitals. One, in my constituency, remains closed, but we have been promised that it will at least be considered for reopening in the next financial year. We shall watch like hawks to make sure that that happens.
One of the most frightening parts of that campaign was the way in which the figures bandied about were so suspect and the analysis on which they were based so shallow. We were told at one point that only 16 per cent. of people in beds in our five community hospitals needed to be there. We challenged the arithmetic, and straight away the figure shot up to 24 per cent. I am still awaiting further explanation of how a raft of other occupants in beds seem mysteriously to have dropped out of the calculations; they would probably take the 24 per cent. up to about 40 per cent. or 50 per cent. When the PCT finally gave way, it found—surprise, surprise—that, as my right hon. Friend the Member for Penrith and The Border observed in his case, lots of people would end up blocking beds in the general hospitals if the community hospitals closed. What a surprise that was. However could it not have guessed that, if it had given a little thought in advance?
The trouble with many health issues is that cases are put forward, for change or inaction or not doing that which should be done, on bogus grounds, and on rationalisations caused fundamentally by a shortage of funds. That leads me to the case of my constituent, Mr. Brian Jago, which I have briefly raised once before. He suffers from multiple myeloma, which hon. Members may know is a cancer of the blood. It is a cancer for which there is no cure. The conventional forms of radiotherapy and chemotherapy may work for a little while, but there will always be a relapse.
However, as I have recently discovered because of my acquaintance with this case, there have been some breakthroughs. In particular, there is a new drug, Velcade, which has been licensed in this country but not yet given its guidelines by NICE—the National Institute for Health and Clinical Excellence. When Mr. Jago came to see me, he explained that a bed had been booked by his consultant in the local major hospital in Southampton for him to start receiving Velcade, only
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for it to be decided by a body called the district prescribing committee that it was not prepared to prescribe the drug for him. I thought that that was a strange state of affairs, because the drug was not being denied to him purely on cost grounds, but because there was insufficient evidence of its efficacy.
Considering that Mr. Jago was being treated by top consultants in Southampton, who are among the world's leading experts on that particular medication, I wondered how a committee of people who are not world experts in such medication can effectively countermand the advice of the consultants. One would have thought that the consultants would be in the best position to know. So I wrote to the chief executive of the Southampton hospitals trust to request that if the issue was money, the committee should say so. Then, at least, Mr. Jago would have the opportunity to borrow the £15,000 that he needs and perhaps get it back, perhaps not in this financial year but in some future financial year when the guidelines have been issued and the treatment is available.
To my surprise, I received a reply that stated that
"there were concerns about the complexity of the trial's statistical data, the lack of quality of life data, the relatively small clinical advantage seen over dexamethasone"—
the more conventional chemotherapy—
With a little help, I did some research on the issue. I shall not bore the House with too many details, but in June 2003, the conclusions of the specialist journals were that
the clinical name for Velcade—
"a member of a new class of anticancer drugs, is active in patients with relapsed multiple myeloma that is refractory to conventional chemotherapy."
By September 2004, the journals were reporting that
"bortezomib provides a cost-effective treatment option and the best value (in terms of cost/life-yr gained) among the currently available therapeutic options for relapsed, refractory myeloma."
By June this year, the results of a major study concluded:
"Bortezomib is superior to high-dose dexomethasone for the treatment of patients with multiple myeloma who have had a relapse after one to three previous therapies."
An editorial in the leading journal, The New England Journal of Medicine, stated that the take-home message of the trials was that
"bortezomib is an effective therapy against relapsed myeloma: a fact to which anyone who has used the drug can attest. It is a much-needed additional tool against this devastating disease."
Why is it then that a district prescribing committee in a regional health authority thinks that it knows better? I think that it has something to do with the fact that the Government have repeatedly stated that the absence of NICE guidelines for Velcade should not be taken as a sufficient reason not to prescribe it. Therefore, the committee has had to cobble together some pseudo-medical guff as an explanation for refusing to prescribe it. Once the guidance comes in, the committee will be in a very difficult position if it wishes to prescribe that drug.
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There are a number of anomalies. If Brian Jago lived in Scotland or Wales he would be able to receive that treatment purely on the say-so of his consultant. There would be no question of a committee of that sort standing in his way. The advice I have had to give him is to live in another part of the country for a time, get himself registered with the NHS locally and try his luck to see whether that will save his life.
Another aspect of the contradictions in the situation is that the treatment that the consultant is being prevented from prescribing—on grounds of cost, I am sure—is less expensive than giving Mr. Jago another bone marrow transplant, which the consultant could do on his own authority and which would cost about £10,000 more than the £15,000 for Velcade.
Finally, although I do not want to cast aspersions on people or groups in the community who suffer from any disease, it is a fact that if someone were in the country illegally and was horribly stricken with AIDS, the medication that they would be given—given—by the same hospital trust would be more expensive than the medication that my constituent, who has paid into the NHS all his life, is being denied.
There is something terribly wrong with that situation. It may be put right in about six months' time when the guidance comes through, but that may be too late for Brian Jago. Although we are busy wishing ourselves a merry Christmas, it will not be a very merry Christmas for him and people in a similar situation.
4.26 pm
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