HC Deb 30 June 1998 vol 315 cc139-40
6. Mr. Steve Webb (Northavon)

To what extent health authorities will be able to disregard the guidelines issued by the proposed national institute for clinical excellence. [46606]

The Minister of State, Department of Health (Mr. Alan Milburn)

We shall be consulting shortly on our proposals for the national institute for clinical excellence. We intend that its guidance will apply to all health authorities. We do not expect that any health authorities or individual clinicians will disregard advice from the national institute, but they will need to take account of local circumstances and the needs of individual patients when implementing guidance.

Mr. Webb

I am grateful to the Minister for that response. I tabled the question because some of my constituents who would benefit from using beta interferon to treat multiple sclerosis cannot receive that treatment because they live in Avon. However, if they lived in Somerset, they could receive that treatment. Some of my constituents have paid privately for the treatment and are benefiting from its use. Will the Minister give a cast-iron assurance that the national institute for clinical excellence will introduce a guideline, stating that this drug works and is effective, that will be followed uniformly across the country?

Mr. Milburn

I am aware of those concerns and of the particular problems experienced in Avon. Department of Health officials have examined carefully Avon health authority's policy on beta interferon. It is fair to say that we have the worst of all worlds at present: too many unproven treatments are introduced into the national health service too quickly while too many proven treatments, on both cost and clinical grounds, are introduced too slowly. The consequence is a lottery of care. The national institute and national service frameworks are about guaranteeing fair access to treatment throughout the country. I hope that, when we publish our proposals shortly, the hon. Gentleman will welcome them.

Mr. Barry Sheerman (Huddersfield)

Does my hon. Friend agree that clinical excellence is at the heart of a good-quality NHS, and should not we be wary this week of being carried away? We have a good NHS, but it could be a darn sight better. For 35 years, it let many people down because the Tories were running it. Many people have been let down by the NHS, and it is our duty to look forward to the next 10, 20 and 50 years. We must ensure first, that the Tories never get their hands on it again and secondly, that we make it as good for every British citizen as it possibly can be.

Mr. Milburn

My hon. Friend is absolutely right. The best in the NHS is still the envy of the world. We may not have the best football team in the world—time will tell about that—and we certainly do not have the best cricket team in the world, but we do have the best health care system in the world. We should not talk down the prospects of the NHS. We want it to continue to expand and thrive, and to guarantee excellence and high standards everywhere.

Mr. Philip Hammond (Runnymede and Weybridge)

The Conservative party welcomes the pursuit of clinical excellence, but the Secretary of State has said that the function of the national institute for clinical excellence will be to give a strong lead on clinical and cost effectiveness. Is it not inevitable that NICE will become part of the rationing mechanism, ruling out the use of certain drugs, treatments and procedures within the NHS? What assurance can the Minister give that, combined with cash limits on general practitioners' prescription budgets, NICE will not place intolerable restrictions on clinical freedom?

Mr. Milburn

I welcome the hon. Gentleman to his first formal appearance at health questions. I assure him that NICE is not a national council for rationing, and I remind him that it was the previous Conservative Government who introduced cash-limited budgets for GPs.

Mr. Paul Flynn (Newport, West)

When the House looks back at the NHS in 50 years' time, does my hon. Friend think that one of the causes of celebration will be that the Government challenged the two main causes of waste and inefficiency in the NHS now—the faith in the omnipotence of the individual clinician and the fact that so many decisions are taken for reasons of commercial profit? Will the Government redouble their efforts to ensure that we break away from so much of the mythology-based medicine from which we suffer now and go on to science-based and evidence-based medicine?

Mr. Milburn

I think that the NHS wants evidence-based medicine. I do not think that there has been a time in the past 50 years when the clinical professionals, who, after all, deliver the quality of care that we all want to see for our constituents, have been so geared to improving standards. The Government want a partnership to be forged between the Department of Health and the clinical professionals—in particular, their leaders—to ensure that standards are as high as possible everywhere inside the NHS, and that effectiveness is the driving force for treating patients.