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Health and Social Care Bill

moved Amendment No. 101B: 101B: Clause 50, page 25, line 46, at end insert— ““(6) The reference in subsection (1) to improving economy, efficiency and effectiveness shall include in particular— (a) financial savings likely to be generated as a result of the recommendations, (b) economic gains likely to arise as a result of the recommendations, and (c) improvements in the effectiveness of patient care likely to arise as a result of the recommendations, in so far as such improvements take advantage of medical technology.”” The noble Baroness said: I am speaking for my noble friend Lord Howe and myself on this amendment. In Clause 50(1), the Bill proposes: "““The Commission may undertake or promote comparative or other studies designed to enable it to make recommendations … for improving economy, efficiency and effectiveness in any activity mentioned in subsection (2)””." Subsection (2) outlines those activities. Amendment No. 101B seeks to broaden the scope of the comparative studies to include the wider benefits and savings that medical technologies can bring. This is particularly timely given the Heath Select Committee’s recent report on NICE. The committee said of the NICE process that, "““it is also vital that the system is accurate and reflects the real costs to society and the benefits to patients””." The Government agree that, while this is a complex area, the issue of how NICE takes into account the wider benefits and costs is a very important one and that it warrants further consideration. I hope that the Minister will give this item further consideration today. Since the Care Quality Commission will take over the functions of the Healthcare Commission, including its role in ensuring implementation of NICE guidance, it is important to equip the new Care Quality Commission with the power to do so in an effective way. We talk a lot about joined-up government, and I applaud the appointment of Dame Carol Black, who works across the Department of Health and the Department for Work and Pensions. I am sure that she would welcome a little help from the CQC that would look beyond the costs and benefits delivered solely to the NHS. For example, where medical technologies enable people to continue in employment rather than have to claim incapacity benefit, those costs and benefits should be recognised. A good case in point is the cutting edge technology Osigraft, which can be used to accelerate healing a bone following a break. Used during surgery, it can avoid the need for further operations and the resulting disruption to a patient’s working life. New improved implants to replace damaged hips and other joints are being developed using newer materials. The impact on a patient’s ability to continue in employment, thanks to increased longevity of the implants or their ability to improve the patient’s mobility, should be taken into account. Currently, only the net cost and benefit to the NHS are looked at. My final example is the improved insulin pumps, which provide a convenient yet sophisticated treatment for diabetic patients, benefiting their quality of life and equipping them to lead normal and productive lives. They are far preferable to multiple daily injections for many people. Unfortunately, five years after receiving NICE approval, there remains a pronounced variation in access to the pumps according to patient groups, including the members of the Medical Technology Group, which is a coalition of patient groups, research charities and manufacturers of medical technologies. I declare an interest as chair of the Association of Medical Research Charities. Our amendment, at Clause 50(6)(c), seeks to redress the balance between medical technologies and drugs and to recognise the benefits that technologies can bring to patients. The Health Select Committee’s report on NICE stated that there are problems with NICE’s topic selection, and, "““Only a few selected medical technologies are chosen as suitable for assessment as technology appraisals””." As a country, our record on the uptake of innovation within the NHS is poor. Only 4.8 per cent of the NHS budget is spent on medical technology, compared with the European average of 9.4 per cent. As a regulator of health and social care, the CQC should rectify this situation. The Health Select Committee, in its concluding remarks, stressed that NICE requires the backing of the Government. NICE must not be left to fight a lone battle and support cost and clinical effectiveness in the NHS. Paragraph (c) of our amendment supports the Select Committee’s view. Again, I hope that the Minister will support the Select Committee here. The recently formed Health Innovation Council—unfortunately shortened to HIC, which sounds like something to do with the alcohol industry—is a good idea. It has been established and is chaired by the noble Lord, Lord Darzi. It covers technologies as well as pharmaceuticals and other interventions. It seeks to deploy a strategy for speeding and embedding innovation across health and social care. In the light of that, I hope that the Minister will recommend the amendment to her ministerial colleague. I beg to move.