HC Deb 01 February 2000 vol 343 cc899-901
10. Dr. Ian Gibson (Norwich, North)

What plans he has to provide resources for drugs recommended by the National Institute for Clinical Excellence. [106247]

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

New drugs and treatments are constantly being introduced to the NHS. The cost of those treatments—whether or not they have been referred to the National Institute for Clinical Excellence—is met from the rising resources allocated to health authorities. Those resources increased by 6.6 per cent. this year and will increase by 6.8 per cent. next year. NICE guidance will tackle the different local interpretations of evidence that have led to unacceptable variations in access to treatment and care.

Dr. Gibson

Does my hon. Friend agree that drugs, such as Taxotere, which is extremely effective in advanced breast cancer, and Taxol for ovarian cancer, are not being spread throughout our population? Many women are not being given the right to be prescribed them. Does he agree that we need to allocate more resources to that matter? If NICE finally comes to its senses and realises that those drugs are effective, will my hon. Friend supplement the budgets of health authorities which want to use those drugs to treat everyone who would benefit from them?

Mr. Denham

My hon. Friend will understand that it would be wrong for me to comment on topics that are under proper consideration by NICE. However, in general the problem is often one of different local priorities—different views of the evidence. The whole point of referring key drugs to NICE is to provide consistent guidance through the NHS to identify those drugs that are both clinically effective and cost effective, and which represent a good use of NHS resources. When NICE produces such approved guidelines, we expect NHS organisations systematically and consistently to take account of them. Clinical governance and the Commission for Health Improvement will help to ensure that.

We are keen that clinically effective and cost-effective treatments are spread more quickly throughout the NHS than they have been in the past. The issue of authoritative guidance from NICE will help to ensure that and will tackle the unacceptable variations to which my hon. Friend has drawn attention.

Mr. Douglas Hogg (Sleaford and North Hykeham)

The hon. Gentleman will be aware that I have raised in the House and in correspondence the relative unavailability in Lincolnshire of beta interferon. He will understand that we all welcome the reference of beta interferon to NICE. However, does he realise that the problem is the lack of resources in Lincolnshire? Unless he is willing—in the event of a positive recommendation from NICE—to put more resources into the authority's budget, it will not be possible to give expression to the institute's recommendation.

Mr. Denham

Again, it would be wrong for me to comment on a particular drug that is being considered by NICE, but I have two things to say to the right hon. and learned Gentleman. The system that has led to very uneven availability of this drug and others was introduced by the previous Government. The existing guidance on the use of beta interferon was introduced by the previous Government, and that is where the problem originated. It is precisely because we do not find such a situation acceptable that we have set up NICE, and we have referred several drugs to it.

I believe that people locally are taking different views of the evidence, which leads to differences in the availability of different treatments. When we have guidance from NICE, that will be consistent and authoritative and we would expect people taking decisions to take full account of it.

Mr. Denis MacShane (Rotherham)

In welcoming NICE, which will put an end to the Tory racket of postcode prescribing, is my hon. Friend aware that there are a great many rising expectations of NICE, and that if NICE strikes a drug that many believe is of use off the list that is available on the NHS, that will greatly disappoint many people? Is he, in his discussions with NICE, drawing its attention to the need to make more drugs available, not fewer?

Mr. Denham

NICE is aware of the resources that are available to the national health service. It is aware that those resources are rising and that spending on drugs has increased faster than the resources available to the national health service.

The good news for my hon. Friend is that NICE is taking its decisions in the context of a Government who are committed to investing in the national health service and to increasing that investment, because we certainly want to ensure that clinically effective and cost-effective treatments which are a good use of those resources are made available in the national health service. That is so very different from the record of the Conservative Government, who introduced a system of postcode prescribing which determined what sort of treatment a person could obtain. The Conservatives now have a new policy—they want to do away with the previous one and simply tell people that they can obtain treatment only if they can afford to pay for it.

Rev. Martin Smyth (Belfast, South)

I understand the problem to which the Minister refers, but what answer would he give to the lady who wrote to me to say that she had taken part in randomised testing, at the end of which, after she had found benefit from the treatment, she was told by the doctor that she had been taking not a placebo but beta interferon, but that, because of the restrictions, it was unlikely that she would be able to get it in future? Surely the hon. Member for Norwich, North (Dr. Gibson) was emphasising an issue that needs to be addressed, namely, to provide effective treatment throughout the country.

Mr. Denham

One of our problems is that the results of proper drug trials are sometimes interpreted differently by different clinicians and different health authorities, which can lead to a difference in the pattern of provision. The great advantage of NICE is that it brings together leading clinicians within an organisation that draws heavily on the expertise not just of clinicians, but of managers and of patients' groups, in order to make an authoritative assessment of the evidence emerging from those trials.

I believe that that will be a great strength to the national health service, because it will mean that the advice that is available to decision makers is based on the best evidence about what works clinically, is cost-effective and is a good use of NHS resources. I hope that that will mean that those patients who may be in the position that the hon. Gentleman's constituent describes get treatment if that treatment is clinically effective and cost-effective for them.