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Department of Health

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 onto 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 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 The £3.5 million that was withdrawn resulted almost directly in one of the appraisal panels being closed.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 decision—by all accounts, the drug is effective—but 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.