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Department of Health

I have not come prepared to give a speech, but I should like to comment briefly on patient safety. I congratulate the Health Committee on an excellent report and my right hon. Friend the Member for Rother Valley (Mr. Barron) on introducing the debate. I turn first to internet sales and self-medication, although the report does not cover that particular aspect. We are reaching the point where we have to think about regulating internet sales of medicines. A growing number of people are buying medicines that are available in this country and cheaper on the internet or that are unavailable in this country and have potential risks attached to their use. I am worried that people may be putting themselves at risk by self-medicating in this way. I am told that some of the information associated with these products that is given on the internet can be inaccurate. People should therefore use it with caution. I ask my hon. Friend the Minister to consider that. Parallel trading is of even greater concern to me. Britain is one of the leading research countries in the discovery of new medicines. We have a very proud record, going back to the early sulphonamides and leading up to some of the most advanced anti-cancer drugs of today. That fine record continues to thrive, for various reasons. We have a good science base. The universities produce excellent scientists and medical people who do the research. We have tremendous hospitals that carry out excellent clinical trials, despite what has been said. The whole environment in Britain is conducive to the discovery of first-class medicines. The pharmaceutical industry is of course profitable, as we have just heard. The pricing structure for the purchase of drugs by the national health service aids in the discovery of drugs in this country because medicines are sold at a higher price to the NHS than they are in many other countries throughout the world, including in Europe. Products that are available in this country can also be bought in Greece, but a country such as Greece does not contribute to the research and development of drugs to anywhere near the degree that Britain does. A product will be on sale in Greece, and in many other countries, at a much cheaper price than in Britain. The pharmaceutical companies in, for example, America, Germany and Britain export their products to countries such as Greece and Bulgaria with foreign-language packets and foreign-language inserted leaflets, so that the patient knows about all the side effects. An entrepreneur can therefore pick up those products in Greece much more cheaply than he or she can buy them in this country. The entrepreneurs then trade them back to Britain, where many may have been made in the first place. There is a requirement to repackage the product if the box and the leaflet inside it have been printed in a foreign language. Therein lies the difficulty. The boxes are reopened, the leaflets are removed, new leaflets are put in, sometimes new labels are stuck over the French or Greek on the box and, often, even the boxes are reprinted. The product is then sold through the outlets that are commonly available in this country. That might appear okay, but there are problems. Earlier this year, the Science and Technology Committee visited the small African country of Malawi. We split up into two teams—an agriculture team and a health team—and I joined the health team. We visited hospitals in Lilongwe and elsewhere in the country. I visited a small district hospital in the centre of Malawi, which orders its drugs for some very sick patients from the central stores in Lilongwe. They are supposed to reach the hospital on the back of a wagon. Unfortunately, corruption is rife in many African countries as in many countries throughout the world. Many drugs do not reach the patients; they fall off the back of a wagon into the hands of a criminal entrepreneur. Consequently, patients die of tuberculosis, AIDS, HIV and all sorts of tropical diseases. They die as a result of parallel trading. The entrepreneur trades the product that has been exported from a western country to Africa back to the western country because it is available much more cheaply in the African country than it is in, for example, Britain. Those parallel traders cause immense damage. In repackaging the products and sticking in another leaflet, mistakes can be made. For example, the drugs can be mixed up. However, I am even more worried about parallel trading from what I heard recently. As I said earlier, my great worry is counterfeiting. The trade in counterfeiting drugs is growing at an enormous pace. People are copying drugs all over the world. Last evening, at a joint meeting of the all-party group on the packaging manufacturing industry and the all-party group on pharmacy, I heard that the counterfeiters are professional and are even buying the same packaging material as the professional companies use—for example, Pfizer in Kent. Obviously they do not have the same careful production processes and, in particular, they do not have the same quality control processes. Last night, we were shown pictures of drugs that had been counterfeited. They had been made chemically, using the same processes, but there are impurities in all chemical processes. Our pharmaceutical companies have good quality control to ensure that there are no dangerous impurities in the drugs on the market in our countries. So, what happens? A drug is counterfeited, often with impurities in it, and placed in packaging identical to that produced by firms such as Pfizer, GlaxoSmithKline and AstraZeneca. We were shown examples of those packages last night. When they were placed side by side with the real ones, we could hardly tell the difference. Inside the packages, the leaflets and blister packs also looked authentic. When we in the audience were asked which was the authentic drug and which was the counterfeit, or parallel-traded, drug, it was very difficult to tell the difference.