HC Deb 30 March 1999 vol 328 cc845-6
4. Mr. Paul Burstow (Sutton and Cheam)

If he will make a statement on the provision of beta interferon in the NHS. [77701]

The Minister of State, Department of Health (Mr. John Denham)

All health authorities were issued in 1995 with guidance that covered the use of beta interferon for the treatment of multiple sclerosis. It recommended that prescribing should be initiated by hospital specialists where clinically appropriate. The costs of prescribing are expected to be met within health authority allocations, taking account of local priorities.

Mr. Burstow

I am grateful for that reply. May I draw the Minister's attention to two cases in my constituency? Josephine Timms, a mother with a young family, and Adrian Donno, a young man with a promising career ahead of him, were each diagnosed with multiple sclerosis last July. Both were recommended by consultant neurologists for beta interferon prescription, but both are still waiting.

Every time they have a further attack, they become more dependent and more disabled. The longer they wait, the more likely it is that they will not fit the health authority's criteria for prescribing, which require them to demonstrate that they can walk unassisted without stopping for at least 100 yd.

Does the Minister agree that the failure to prescribe treatment that the consultant neurologists say will be beneficial to those patients and to others like them lets those people down and leads to a reduction in their quality of life?

Mr. Denham

Obviously, I shall take an interest in any individual case raised by an hon. Member. However, we should be clear that there are continuing questions about the clinical effectiveness and cost effectiveness of beta interferon, the level of benefits achieved, which patients will benefit and for how long, and how the benefits compare with those of supporting MS patients through, for example, specialist nursing care. Health authorities and clinicians rightly take those and other factors into account when they set local priorities.

Mr. Gordon Prentice (Pendle)

As the Minister tells us, beta interferon can be prescribed only by a hospital consultant. The problem is, however, that, after initial diagnosis, many people with multiple sclerosis do not see a hospital consultant for years. They therefore do not know whether beta interferon would be the drug to help them. Would it not be sensible to put in place some recall system so that people with MS have the option to see a consultant if they feel that beta interferon or some other drug might help them, or if they are not coping as well as they should with MS?

Mr. Denham

I shall consider my hon. Friend's suggestion carefully. We must ensure that clinical and cost-effective treatments are spread throughout the national health service as quickly as possible, and that is one of the roles of the National Institute for Clinical Excellence, which will provide clear and authoritative advice on key treatments and procedures. Subject to the outcome of consultation on the discussion document and appraisal by NICE, we are minded to refer beta interferon to the institute.

Miss Ann Widdecombe (Maidstone and The Weald)

Is the hon. Gentleman aware of an exchange about rationing in the health service that took place last year between me and the Minister for Public Health, in which I asked a very simple question: Is there rationing or is there not? The answer I got was very simple: No".—[Official Report, 15 December 1998; Vol. 322, c. 746.] In view of the evidence put to the House by the hon. Member for Sutton and Cheam (Mr. Burstow), does the Minister now wish to revise that answer?

Mr. Denham

No.

Miss Widdecombe

Is there or is there not rationing of beta interferon? Is there or is there not rationing of Aricept? Is there or is there not rationing of Ironotecan? Is there or is there not rationing of Taxol? If not, why cannot those patients who are prescribed those drugs obtain them?

Mr. Denham

The reality is that priority setting is a feature of every health care system in the world. It happens to be the case that the national health service is fairer, more equitable and more efficient than the privatised alternative that the hon. Member for Rutland and Melton (Mr. Duncan) advocated earlier this week. While the Conservatives are giving up on the national health service, new Labour is building a new national health service.

Miss Widdecombe

Will the hon. Gentleman answer a simple question? If he is denying rationing in the health service, will he explain to the House, and to those concerned people who would like to obtain drugs and operations that are not available, his definition of the difference between rationing and a priority?

Mr. Denham

Under the health system advocated by the right hon. Lady and her hon. Friends, any access to health care would be rationed by the ability to pay.