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NHS Patients (Access to Medicines)

I am very surprised by the hon. Gentleman' response, not least because, if he has read the report, he will know that Mike Richards looked at a spectrum of alternatives. The first point—the important point—is that we will no longer withdraw NHS treatment from people who have to pay for a drug that has been recommended by their clinician but which is not available on the NHS. The hon. Gentleman says that he raised this issue months ago, but I never heard a single word about it from Conservative Front Benchers until the Conservative party conference, three months after we had announced the review. Yes, there was a question a year ago from the Opposition Back Benches, but it was not followed up at all by those on the Front Bench. Yet, suddenly, the Mr. Know-alls have always been aware of this problem and always been determined to resolve it. Why has Professor Richards, after talking to all his colleagues, come up with this proposal? At one end of the spectrum, there is the current, rather cruel, practice. Incidentally, I too pay tribute to the hon. Member for Billericay (Mr. Baron) for the work that he has done on behalf of Linda O'Boyle's family. At the other end of the spectrum, there is something that Mike Richards calls top-ups. I do not want to get bogged down in the terminology, but the understanding of people in the profession was that some people were concerned about the change in practice, and a thorough debate took place on the issue. The understanding was that a top-up system would involve an NHS patient being offered a range of choices, one of which would involve the patient in bed No. 1 being offered a drug that was not available on the NHS and paying the NHS for it, while the patient in bed No. 2 could not afford to pay for the same drug. However, Mike Richards points out that the only people who were vehemently proposing that option were the people who felt that a tax-funded system could not survive and that, at some stage, we would need to move to an insurance-based system. They are the only people, Mike Richards says, who put forward that view. That is top-up. What Mike Richards has said, of course, is that we should not withdraw this treatment; we should ensure that NHS treatment continues; we should allow the patient to pay for that treatment; but we should not under any circumstances—to reiterate a point put to me in a consultation by the hon. Member for Billericay—endanger the principles of the NHS. The system of top-ups would, however, endanger that principle. [Interruption.] This is a serious issue, so let us not have barracking from the gallery; let us rather try to understand what Professor Richards has done in a very important report over a short period. We will deal with Europe and all the other peripheral issues, but what Professor Richards has said is that we cannot carry on with this cruel system, but neither can we allow the NHS to be used to subsidise private care. I do not know the current position of Conservative Front Benchers on this issue. It has been all kinds of things over the last 10 years and I am not sure what it is today on this particular Wednesday; it might well have changed again—[Interruption.] Sorry, it is Tuesday today, so it will no doubt change again tomorrow. The real issue is this: what Mike Richards says is that we should have separate care, perhaps provided in a private facility in an NHS hospital; that is fine, because we allow private care in NHS hospitals. If such care in not available in an NHS hospital, the patient can get the drug from a private practitioner and have it administered at home, which is what happens in Birmingham. However, NHS care will not be withdrawn from such patients and they will be allowed to buy those drugs. The final point made by the hon. Member for South Cambridgeshire (Mr. Lansley) was about flexible and value-based pricing, which was in the Office of Fair Trading review of the pharmaceutical industry a while ago. The hon. Gentleman and the Conservative party need to understand this: either we keep the current system, which Labour Members value, of reaching a voluntary agreement with the pharmaceutical industry through the PPRS or we move to reference pricing—the European model. I believe that we would lose out from that system. [Interruption.] The hon. Member for South Cambridgeshire asks why we did not introduce value-based pricing earlier. The answer is that we need to negotiate it with the pharmaceutical industry. If we do not negotiate it, we will have to introduce it through legislation, which is not the route we want to take. The negotiating route has led us to a patient-access scheme, which is being used for some drugs, and we will soon, I hope, conclude our negotiations and have a flexible pricing scheme. The worst scheme would be the Conservative policy launched a couple of days ago, which amounts to a huge bureaucracy with every drug having to be evaluated through the system. We would lose the voluntary agreement with the pharmaceutical industry and probably lose some major research and development in pharmaceuticals. I think that Conservative Members need to get their act together; as far as I can see, the policy seems to be put forward by ““Confused of Conservative central office””.