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NHS Patients (Access to Medicines)

I thank the hon. Gentleman for his welcome for the statement. He says that it is a remarkable U-turn, but this guidance has been around for many years. We can track it back to the early '80s, under the Thatcher Government, and it was there before that. [Interruption.] He says from a sedentary position that it is a U-turn from what I said, but I said that if we allowed NHS care and private care to be given together—I talked about an episode of treatment, to introduce a new variation into all the descriptions, back in December last year—that could be the end of the founding principles of the NHS. It could be, and Mike Richards has accepted that it could be, which is why separate care is an important part of his proposals. [Interruption.] Everyone in the House apart from those on the Conservative Front Bench understands that Mike Richards' terms of reference were to defend the principles of the NHS, and that combining private and NHS care would be the route to an insurance-based system and the end of a taxpayer-funded system. The hon. Gentleman said that the proposal would have to go hand in hand with greater availability. That is what Mike Richards recognised, and that is why a large part of my statement was concerned with that. The hon. Gentleman asked the reason for the delay in NICE's appraisal of the drugs. I understand that it is due to the tail in the system. We committed ourselves to a more rapid appraisal a year ago in our cancer strategy, and as new drugs come in we can move quickly, but the old drugs are still being appraised under the old system. It will take us some time to work our way through the backlog, but NICE has already announced that it is increasing the number of appraisal teams and standing committees and starting more appraisals earlier, so I think that the time scale is realistic. The hon. Gentleman mentioned ministerial referral, which was also mentioned by the hon. Member for South Cambridgeshire. We are not handing the whole process over to NICE and taking politicians out of it completely, but once a drug has been referred to NICE, the process becomes a NICE process, independently run. NICE also has an enormous role in the earlier process of selecting drugs to be referred. It is responsible for the consideration panels of experts before the matter is sent to the referral oversight group, which consists of clinicians. The ministerial sign-off for which my right hon. Friend the Minister of State is responsible is a very short part of that process.