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House of Lords Official Report Vol. 752 Thursday No. 120 27 February 2014 PARLIAMENTARY DEBATES (HANSARD) HOUSE OF LORDS OFFICIAL REPORT ORDER OF BUSINESS Questions NHS: NICE-appraised Medicines...............................................................................1003 Community Life ..........................................................................................................1005 Vocational Training: Young People............................................................................1008 Ukraine.........................................................................................................................1010 Syria and the Middle East Motion to Take Note ..................................................................................................1013 Marriage (Same Sex Couples) Act 2013 (Consequential and Contrary Provisions and Scotland) Order 2014 Marriage (Same Sex Couples) (Jurisdiction and Recognition of Judgments) Regulations 2014 Marriage of Same Sex Couples (Registration of Shared Buildings) Regulations 2014 Marriage of Same Sex Couples (Use of Armed Forces’ Chapels) Regulations 2014 Overseas Marriage (Armed Forces) Order 2014 Consular Marriages and Marriages under Foreign Law Order 2014 Motions to Approve .....................................................................................................1075 Grand Committee Charity Commission Question for Short Debate ....................................................................................GC 369 International Holocaust Remembrance Alliance Question for Short Debate ....................................................................................GC 384 Counterterrorism Practices Question for Short Debate ....................................................................................GC 400 Health: Concussion in Sport Question for Short Debate ....................................................................................GC 413 Young People: Suicide Question for Short Debate ....................................................................................GC 430 Written Statements ....................................................................................................WS 109 Written Answers .........................................................................................................WA 273 £4.00 Lords wishing to be supplied with these Daily Reports should give notice to this effect to the Printed Paper Office. No proofs of Daily Reports are provided. Corrections for the bound volume which Lords wish to suggest to the report of their speeches should be clearly indicated in a copy of the Daily Report, which, with the column numbers concerned shown on the front cover, should be sent to the Editor of Debates, House of Lords, within 14 days of the date of the Daily Report. This issue of the Official Report is also available on the Internet at www.publications.parliament.uk/pa/ld201314/ldhansrd/index/140227.html PRICES AND SUBSCRIPTION RATES DAILY PARTS Single copies: Commons, £5; Lords £4 Annual subscriptions: Commons, £865; Lords £600 LORDS VOLUME INDEX obtainable on standing order only. Details available on request. BOUND VOLUMES OF DEBATES are issued periodically during the session. Single copies: Commons, £105; Lords, £60 (£100 for a two-volume edition). Standing orders will be accepted. THE INDEX to each Bound Volume of House of Commons Debates is published separately at £9·00 and can be supplied to standing order. All prices are inclusive of postage. The first time a Member speaks to a new piece of parliamentary business, the following abbreviations are used to show their party affiliation: Abbreviation Party/Group CB Cross Bench Con Conservative Con Ind Conservative Independent DUP Democratic Unionist Party GP Green Party Ind Lab Independent Labour Ind LD Independent Liberal Democrat Lab Labour Lab Ind Labour Independent LD Liberal Democrat LD Ind Liberal Democrat Independent Non-afl Non-affiliated PC Plaid Cymru UKIP UK Independence Party UUP Ulster Unionist Party No party affiliation is given for Members serving the House in a formal capacity, the Lords spiritual, Members on leave of absence or Members who are otherwise disqualified from sitting in the House. © Parliamentary Copyright House of Lords 2014, this publication may be reproduced under the terms of the Open Parliament licence, which is published at www.parliament.uk/site-information/copyright/. 1003 NHS: NICE-appraised Medicines[27 FEBRUARY 2014] NHS: NICE-appraised Medicines 1004 Lord Walton of Detchant (CB): My Lords, can the House of Lords Minister say what consideration the Government are giving to the availability of the highly expensive so-called Thursday, 27 February 2014. orphan and ultra-orphan drugs that are now coming on stream, which are effectively treating many rare 11 am diseases? Prayers—read by the Lord Bishop of Wakefield. Earl Howe: My Lords, this important class of drugs will be subject to a special evaluation process by the NHS: NICE-appraised Medicines National Institute for Health and Care Excellence. Question That methodology has been worked through and over the coming months we will see NICE evaluating orphan 11.06 am medicines and medicines for highly specialised conditions to inform clinicians in the NHS and, where appropriate, Asked by Lord Hunt of Kings Heath provide a funding direction for those drugs. To ask Her Majesty’s Government what is their response to the report of the NHS Information Baroness Brinton (LD): My Lords, perhaps I may Centre for Health and Social Care, Use of NICE follow on from the Minister’s answer to the noble appraised medicines in the NHS in England-2012, Lord, Lord Hunt, on clinical commissioning groups. experimental statistics, which showed extensive variation The previous year’s report on appraised medicines in patients’ access to new innovative medicines. provided a very helpful algorithm of biologics for rheumatoid arthritis. Will NICE and other organisations Lord Hunt of Kings Heath (Lab): My Lords, I beg involved in these specialist medicines follow a similar leave to ask the Question standing in my name on the algorithm to make it even clearer to CCGs where they Order Paper and I refer noble Lords to my health should not step out of line but must follow clinicians’ interests. advice? Earl Howe: It is important to distinguish between a The Parliamentary Under-Secretary of State, Department technology appraisal, where, if favourable, there is a of Health (Earl Howe) (Con): My Lords, patients have clear funding direction for the NHS—in other words, a right to drugs and treatments that have been approved it must fund the drug if the doctor thinks that it is by the National Institute for Health and Care Excellence appropriate for the patient—and a clinical guideline, that their doctor decides are appropriate for them. where NICE issues best practice advice for the NHS. There can be many reasons for variation in use but we There is no funding direction attached to that. However, are determined to tackle unjustified variation where it clinicians are expected to take account of NICE guidelines exists. in everything that they do. Lord Hunt of Kings Heath: My Lords, I am grateful Lord Kakkar (CB): My Lords, I declare my interest to the noble Earl for that response. Does he agree that as chairman-elect of University College London Partners, one of the conclusions of the report is that there can one of the designated academic health science be a tenfold variation in the take-up of innovative new partnerships. Is the noble Earl content that the funding medicines that have been approved under the NICE arrangements to be put in place by NHS England for technology appraisal programme? Given that it is a the 15 designated academic health science networks legal requirement for clinical commissioning groups are appropriate and will ensure that they can discharge to fund those treatments, as I understand it, what their substantial obligations under their licence agreement, sanctions can be taken against commissioning groups including the adoption of NICE guidance among the which do not fund those treatments? What can patients populations for which they are responsible? do in each area if they are refused such treatments? Is there a process of appeal that they can take their Earl Howe: The noble Lord asks a very important concerns to? question. It is slightly wide of the Question on the Order Paper, which relates to a particular set of statistics. Earl Howe: My Lords, there is a process of appeal. However, I can tell him that I am broadly satisfied Patients can go to their clinical commissioning group with the level of funding for AHSNs, and NHS England or, indeed, to NHS England and ask for the matter has given its commitment to maintain its support for to be specially looked at. However, it is important to them going forward. understand what these figures are and what they are not. They are not intended to be, and do not claim to Lord Campbell-Savours (Lab): If the appeal is to be, a statement of whether certain drugs are being NHS England or the commissioning groups, does that underprescribed or overprescribed in a particular area. mean that they have the right to overrule the decision One has to drill down into the reasons. In fact, when that has been taken by NICE? one does that, for most of the groups of medicines where it was possible to compare observed and predicted Earl Howe: My Lords, patients have a right under use, the report shows that use has increased over time, the NHS constitution
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