Lung Cancer Medicines
Debate between Lord Evans of Rainow and Baroness Manzoor(2 months, 3 weeks ago)
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Lord Evans of Rainow (Con)
My Lords, I share the noble Lord’s disappointment that the company has taken the decision to withdraw Mobocertinib from the market globally. I understand that this decision was taken after the treatment failed to meet its primary end-points in the phase 3 EXCLAIM-2 trial. I assure the noble Lord that, for existing patients, and through a compassionate use scheme for new patients, although this drug was the only NICE-recommended treatment targeted for exon 20 patients, alternative NICE-recommended immunotherapies may be appropriate treatments for patients at the same stage in the disease pathway.
Baroness Manzoor (Con)
My Lords, frequently in the House questions have been raised about the shortage and accessibility of some drugs to NHS patients. With this drug, there are concerns around its efficacy and effectiveness. How is the issue being communicated to patients who are using this drug, because they are vulnerable consumers and patients? How will the Government ensure the efficacy of other drugs and treatments in its place?
Lord Evans of Rainow (Con)
My noble friend raises a very important point about communication. When patients are in receipt of drugs and surgery, it is a very vulnerable time, and it is important they are communicated to in an appropriate manner. Takeda has worked closely with the MHRA, the NHS, and the clinical and patient communities to ensure that details of the withdrawal have been appropriately communicated to the lung cancer community. There is also a direct communication to healthcare professionals, to be distributed together with details of compassionate use programmes. This drug will still be available currently and in the future. Regarding efficacy, it is important that, when drugs are brought to the market, they are successful and do what they were brought on the market to do. If that is not the case, they need to come to an end, unfortunately.
Child Obesity
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
I completely agree with the noble Baroness that aspartame is an issue in diet foods, such as yoghurts and drinks. We work closely with the industry to look at formulations that can help reduce sugar, and a lot of progress has been made. I remember that, as a child, when asked what I would like by my grandmother, I used to say fizzy drinks and she would provide me with something called corporation pop, otherwise known as tap water.
Baroness Manzoor (Con)
My Lords, as my noble friend the Minister will know, obesity rates are highest in deprived areas, followed by higher incidence of mortality and morbidity related to type 2 diabetes, heart disease and strokes. There is also a higher prevalence of food banks in these areas. Can my noble friend say whether there is any correlation between the incidence of deprivation, poverty and food banks? My noble friend Lady Boycott made a very interesting suggestion on the previous Question. How are the Government addressing these issues?
Lord Evans of Rainow (Con)
This is a complicated picture, as many factors contribute to obesity. We know that there are more fast food outlets in deprived areas, offering very large portions of calorie-dense, nutrient-poor food. Buying this type of food can be seen as value for money for people who are struggling financially. We also know that people living in an area of high deprivation are subject to more advertising, thus encouraging the purchase of foods higher in fat, salt and sugar. Food banks offer emergency food provision and people may be accessing these as a short-term measure, so they may not represent the food that is routinely consumed over a long period. The Government are working hard with industry. The reduction of sugar is going on in the reformulation of many products that we all consume, but there is clearly a lot more to be done.
NHS: Hospital Waiting Times
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
I pay tribute to the noble Lord and the forensic accountancy skills that he brings to this place. He certainly brings excellence to debates in your Lordships’ House. The data on the number of people who have died while on waiting lists is not held centrally. The Office for Natural Statistics reports annually on avoidable mortality using OECD/Eurostat definitions. Our excess mortality model does not enable us to estimate how many excess deaths could be considered avoidable based on that definition. To prevent avoidable deaths and maximise outcomes, the NHS triages patients waiting for elective care by reflecting clinical judgment on need, targeting those waiting the longest, and by increasing the number of cancer referrals.
Baroness Manzoor (Con)
My Lords, I am surprised and rather shocked that the department does not hold such important data centrally. Accessibility to good data should be at the heart of evidence-based decision-making, particularly in the NHS, where we know that, for instance, mortality, morbidity and health outcomes are poorer, particularly for black and ethnic minority communities and vulnerable patients. What will my noble friend the Minister do to ensure that that is corrected? As we heard in the previous Question, good governance is based on transparency, accountability, delivery and honesty. If we do not have the data, how is service provision going to be made and improved compared with today?
Lord Evans of Rainow (Con)
My Lords, my noble friend makes a good point. Waiting list management and data collection are held locally by individual trusts and integrated care boards. As such, the department does not centrally collect or hold data on deaths or causes of death on the waiting list. Instead, the Department of Health and Social Care and NHS England measure elective performance using a number of existing robust data collections. The DHSC and NHS England both have statutory duties to promote an effective and comprehensive health service. Within that, NHS England is responsible for holding NHS providers and ICBs to account for their performance. However, my noble friend makes a good point and I will take it back to the department and the Secretary of State.
Deaths: Younger Age Cohorts
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
The noble Lord raises a very important point about mental health. One thing the pandemic exposed is the increasing mental health challenge, not just in young people but across the board. The Government will be launching a major conditions strategy, which will include mental health issues. We expect to notify your Lordships’ House on that in early spring 2024.
Baroness Manzoor (Con)
My Lords, the Government have put a significant amount of money into the NHS, which I welcome. However, the lion’s share of this money has gone into secondary and tertiary care, and, personally, I would have welcomed more money going into diagnostic services and preventative care. Therefore, can my noble friend the Minister say why waiting lists continue to rise, why the NHS is missing key targets and how the Government intend to address this?
Lord Evans of Rainow (Con)
My noble friend raises an important point. The Government have recruited more doctors, nurses, community diagnostic centres and single surgical centres. We are treating record numbers of patients. We know that the waiting list will rise before it comes down, as demand returns to the NHS following the Covid-19 pandemic. This is a good thing, and we urge everyone who is worried about their health to come forward. We are taking action to recover elective services by providing the NHS with record levels of staffing and funding, and by supporting trusts to maximise capacity via a new network of community diagnostic centres, surgical hubs and an increased use of the independent sector. These new investments will make a significant dent in the waiting list. Unfortunately, strike action has led to further increases in waiting lists this year.
Vector-borne Diseases
Debate between Lord Evans of Rainow and Baroness Manzoor(4 months, 3 weeks ago)
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Lord Evans of Rainow (Con)
My Lords, I note that Health Ministers get asked Foreign Office questions, and Foreign Office Ministers get health questions. However, the right reverend Prelate raises a very good point. It is a very topical issue. The UK is a world leader in life sciences, and British science is at the cutting edge of fighting malaria. Our support to public/private product development partnerships has helped saved many lives. This includes support to the Liverpool-based Innovative Vector Control Consortium to develop novel bed nets and next-generation insecticides to overcome the threat of insecticide resistance. Since 2017, we have provided £44 million to develop new insecticides to prevent vector transmission of malaria and other vector-borne diseases. IVCC has developed many ground-breaking technologies, including a novel type of bed net that kills mosquitoes’ resistance to traditional insecticides.
Baroness Manzoor (Con)
My Lords, which vector-borne diseases are prevalent in the UK, and what are the Government doing to address this risk to public health?
Lord Evans of Rainow (Con)
My noble friend raises a very good point. Many of your Lordships will know that the primary vector-borne disease in the UK is currently Lyme disease. However, with climate change, we are likely to see conditions suitable for the establishment of invasive mosquitoes that are currently becoming established in other parts of Europe. These mosquitoes, as well as other species likely to be impacted by flooding, may increase the incidence of mosquito biting. In a warming climate, vector-borne diseases such as dengue and West Nile virus, which currently occur in warmer parts of Europe, will become more likely in the UK. We need to stay vigilant as these diseases may or may not occur in the UK.
NHS Waiting Times: Long-Term Sickness Absence
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
The noble Baroness raises a good point. The Government have announced a health package of £400 million, to be focused specifically on mental health, musculoskeletal problems and the cardiovascular system. A package of digital tools for mental health and MSK, worth £225 million, is expected to be delivered during 2023-24. There is still a lot to be done, but a lot of good work is going on in the pipeline, and I hope noble Lords will see that filter through shortly.
Baroness Manzoor (Con)
My Lords, if you cannot get a GP appointment, you are more likely to be off work for longer. In some parts of the country, one in five people are waiting for over a month, and the NHS data shows that 50% of people are waiting for 48 hours, which is compounding problems with returning to work. Can my noble friend the Minister say what the Government are doing to address this?
Lord Evans of Rainow (Con)
My noble friend raises an important point. The first port of call for the vast majority of citizens in this country is their GP practice, to enable them to be diagnosed and, therefore, forwarded to the relevant NHS services. The Government work closely with GP practices to encourage them to improve the way they communicate with their patients, but there is clearly more to be done.
Respiratory Syncytial Virus: Immunisation Programme
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
I am grateful to the noble and learned Baroness. Yes, I am very much aware of what goes on in the United States, but I also look at what is going on in European countries such as France and Germany. The NHS is ground-breaking in European terms, and I am confident that by 2024 we may have some good news. I am aware of what goes on in America, but that is not always appropriate for the United Kingdom.
Baroness Manzoor (Con)
Can my noble friend tell me how the Government are assessing new vaccines and giving confidence to the public on this issue? How are they tackling vaccine hesitancy and misinformation?
Lord Evans of Rainow (Con)
My noble friend makes a very good point, and the noble Lord, Lord Hallam, often refers to this issue. The latest figures confirm that 95% of parents have confidence in the efficiency of the vaccine and immunisation programme. The Government are committed to tackling vaccine misinformation, which includes ongoing monitoring by the UKHSA of vaccine uptake and attitudes to vaccines.
I refer to my original point—it is very important that we get this right. If we act prematurely and get it wrong, misinformation and conspiracy theories grow from not doing it properly in the first place.
Housebuilding
Debate between Lord Evans of Rainow and Baroness Manzoor(7 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
I am grateful to the noble Lord for his question on Birmingham and for the service that he gave to Hazel Grove over many years. I do not have a specific answer to his Birmingham City Council question because it is too recent and I do not have it in my pack, but I will write to him.
Baroness Manzoor (Con)
My Lords, as my noble friend the Minister will know, SME builders are having a difficult time and are being priced out of the market because of high interest rates and difficulty borrowing money and getting funding in the first place. Can he say exactly what is being done to support these builders? Without them, England would be worse off.
Lord Evans of Rainow (Con)
My noble friend is exactly right. SME builders bring some welcome colour and difference to housing design throughout the country, and it is very important that we have those independent SME builders. The Government are committed to supporting SME housebuilders: last year we launched the levelling-up home building fund, which is providing £1.5 billion of development finances to SMEs and builders to support them to build more homes. The Levelling-up and Regeneration Bill is making changes to support SMEs, making the planning process faster and more predictable so that they can plan ahead.
Blood Donation
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
My Lords, the Welsh Blood Service is responsible for blood collection across Wales. The WBS hosts around 1,200 donation sessions a year, using around 185 venues across Wales and collecting 85,000 units of blood to support 19 hospitals in Wales. The WBS has an active national donor recruitment and retention programme. The system is slowly returning to its pre-pandemic model of collection. The WBS recognises a critical challenge in the recruitment of new donors and is about to launch a five-year strategy, which realises the importance of building and sustaining the blood supply chain for Wales. The four nations of the United Kingdom have very good blood donor services and work closely together, but blood donor services are devolved to Wales and Scotland.
Baroness Manzoor (Con)
My Lords, I wish the NHS a happy 75th anniversary. My noble friend the Minister will be aware that there is a new drug to treat sickle cell anaemia in a crisis, which is proving to be very effective. Can we ensure that people of African and Caribbean descent are not confused and know that they still need to give blood because, although this drug is very effective, there is a significant gap in the blood supplies from those communities within the NHS?
Lord Evans of Rainow (Con)
My noble friend raises a very important point. We welcome the approval and introduction of crizanlizumab to help treat sickle cell patients, and we hope that this promising advance will have a major impact on the reduction of painful episodes and improve the quality of life for patients suffering from sickle cell disorders. Although this is a positive step, it is vital that people living with sickle cell disorders continue to get regular blood transfusions and red cell exchanges. This does not change the increasing need to have patients with ethnically matched blood, so my noble friend raises a good point.
She asked what we are doing. There is a range of techniques to increase awareness of the need to donate. NHSBT continues to invest and to prioritise the diversification of its donor base, and increasing the supply of Ro Kell-negative blood is one of its priorities. It is being supported through increased investment in marketing and the engagement of donors of black Caribbean and black African ethnicity, who are more likely to have this blood type.
Drugs: Supply and Availability
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
The noble Baroness raises a very important point regarding medication for diabetes. She is absolutely right: when a patient is used to a medication, or indeed a device, it can be distressing and frustrating. We are aware of that. We want to assure noble Lords that the DHSC has well-established processes to manage supply issues, working with the supplier to resolve these issues as soon as possible. Where there is perhaps a shortage, it is very important that the patient gets training on the alternative device and that we get them back on to the device that they are familiar with.
Baroness Manzoor (Con)
My Lords, to follow on from the comments of the noble Lord, Lord Patel, Ozempic, a drug approved by NICE, is to be made available to diabetics. The accessibility to this particular drug is poor, and yet it has been made available to non-diabetic patients, such as celebrities. My concerns are twofold. First, what is the access available for diabetic patients to this new and life-changing drug? Secondly, how are the Government ensuring that young girls in particular are not following celebrities in using this drug just to bring down their weight?
Lord Evans of Rainow (Con)
My noble friend raises a very important point. Social media has a detrimental effect on the health and well-being of young girls—celebrities latch on to these things and it goes viral. The prescribers, whether NHS or private, are accountable for their prescribing decisions. They are expected to take account of appropriate national guidance. It is for the responsible clinician to work with their patient and decide on the course of treatment, with the provision of the most clinically appropriate care for the individual always the primary consideration. We will always work with clinicians to ensure that these drugs are prescribed as safely as possible, alongside specialist weight-management services.
Secondary Metastatic Breast Cancer
Debate between Lord Evans of Rainow and Baroness Manzoor
Baroness Manzoor (Con)
My Lords, the audits are very welcome, but nevertheless there is great variation in the way in which innovative drugs are being given to some patients. With the prognosis being much better with new, innovative drugs and treatments, what access is particularly given to those patients?
Lord Evans of Rainow (Con)
My Lords, the Government are committed to supporting timely access for NHS patients to clinically effective and cost-effective new drugs, including for breast cancer. NICE is able to recommend the vast majority of cancer medicines that it appraises. It has also made positive recommendations in all 19 of its appraisals of breast cancer treatments since 2016. This track record has been made possible by the cancer drugs fund, which has benefited more than 88,000 patients as of March 2023, with 102 medicines treating 241 different cancers having received funding. The CDF has enabled breast cancer patients to access promising new medicines such as Enhertu and Ibrance, while allowing for the collection of further data on their clinical and cost effectiveness.
Respiratory Syncytial Virus Immunisation
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
My Lords, I have not discussed the universal RSV immunisation programme for 2023-24 with the Chancellor. However, the independent expert committee, the JCVI, provides the Government with advice on all immunisation programmes, including RSV. For the current year, this advice is to improve the existing targeted programme for children at high risk. Once the JCVI has concluded its robust review of evidence for an expanded or universal programme, I will support the implementation of any changes advised as soon as practicable. This would include talking to the Chancellor to seek budgetary support for a potential programme. I offer the noble Baroness a meeting with the relevant officials following this Question to discuss this important matter further, if that would be helpful.
Baroness Manzoor (Con)
My Lords, as my noble friend will be aware, the RSV vaccine was mostly given to pre-term and premature babies. As he said, a new vaccine is available that will last longer than the previous one. Therefore, can my noble friend the Minister say exactly how the Government will improve the uptake across all immunisation programmes and age groups?
Lord Evans of Rainow (Con)
The Government are committed to child health. After clean water, vaccination is the most effective public health intervention for saving lives and promoting good health. The Government work with the NHS and the UK Health Security Agency to support accurate and up-to-date information on the benefits of vaccines to be available to parents, carers and patients. The NHS has recently concluded a call and recall campaign, where parents, carers and anyone aged one to six who has missed their measles, mumps and rubella vaccine for any reason were invited to their GP to catch up with vaccinations.
HIV Transmission
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
The noble Baroness makes a very good point. We are considering the full evidence from the first year of opt-out testing, alongside the data on progress towards our ambition of ending new HIV transmissions in England by 2030, in order to decide whether to expand this programme to areas other than those with high HIV prevalence. We will also share the findings from the opt-out testing programme with local health systems to inform local decisions on expansion.
Baroness Manzoor (Con)
My Lords, my noble friend will be aware that the drug PrEP is very effective in preventing HIV transmissions. What are the Government therefore doing to ensure that it is available to those who need it, and when will it be available? I too fully support the opt-out clinics; they are making significant savings and I urge the Government to expand them across the country.
Lord Evans of Rainow (Con)
I thank my noble friend for that question. We know that the HIV prevention drug PrEP is extremely effective at preventing HIV transmission. We are developing a plan to improve access to PrEP for key groups and in settings outside of sexual health services, as part of our HIV action plan commitments.
Eating Disorder Services: Men
Debate between Lord Evans of Rainow and Baroness Manzoor
Lord Evans of Rainow (Con)
The noble Lord raises a very good point, which I agree with. I will take his excellent question back to the department and come back to him on it. In terms of this Question, a significant number of young people affected are females and a relatively small part are young men, but the whole strategy will encompass all men and women.
Baroness Manzoor (Con)
My Lords, as the Minister has just said, around 70% of those affected by eating disorders are girls and women. However, there has also been an increase among young boys and men. Can my noble friend say what relationship boys and men have with their body image and what perception they have of it, in light of their physical and mental health? What specific resources will be dedicated to this issue?
Lord Evans of Rainow (Con)
That is another excellent question. Poor body image can affect anyone at any point in their lives. The pressure to achieve an idealised body image has wide-ranging consequences for mental and physical well-being. The growth of social and digital media has increased exposure to images of beauty which are unrealistic and, in some cases, untenable. Body image is recognised as a risk factor for mental health problems and is more commonly identified as a key risk factor for eating disorders and unhealthy eating behaviours. Members with teenage children in their families will know how much time they spend on their mobile devices.
Immunisation: Winter 2023-24
Debate between Lord Evans of Rainow and Baroness Manzoor(1 year, 2 months ago)
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Lord Evans of Rainow (Con)
I thank the noble Baroness for her question and pay tribute to the work that she does on behalf of us all as the allergy champion in Parliament. In line with the JCVI recommendation, the NHS currently offers a targeted monoclonal antibody programme to a small number of infants at high risk of severe complications from RSV infection. However, there are potential changes to this programme: a new monoclonal antibody which provides longer-term protection than the one currently used has been developed, and the JCVI is reviewing this in time for the 2023-24 season. The new monoclonal antidotes and vaccines are being reviewed by the JCVI for potential expansion of the current programme, including a universal offer. The JCVI is expected to conclude advice on this later in 2023. I assure the noble Baroness that I have asked for a specific date, and once I receive one I will certainly notify her.
Baroness Manzoor (Con)
My Lords, can my noble friend the Minister say why the Government are advocating the vaccination of healthy, not-at-risk children for Covid-19?
Lord Evans of Rainow (Con)
I thank my noble friend for that question. The Government are guided by the independent JCVI on vaccinations and immunisations. The intention of the vaccination offer to children is to increase the immunity of vaccinated individuals against severe Covid-19 in advance of a potential future wave. When formulating advice in relation to childhood immunisations, the JCVI has consistently maintained that the focus should be on the potential benefits and harms of vaccination to children and young people themselves; prevention of severe Covid-19 hospitalisations and deaths in children and young people is the primary aim.