My Lords, I congratulate my noble friend Lord Sharkey on introducing this debate, which has actually been quite worrying for those of us who believe that unless we maintain the UK’s position in medical research, UK patients will continue to lose out. Only this morning we heard in the news about how our performance in diagnosing and treating cancer is well behind that of our neighbours in Europe, so this is no time to be imposing further restrictions on the availability of new oncology medicines for UK patients.
My noble friend Lord Sharkey has outlined his concerns, which I share, about NICE’s new affordability cap. As the noble Baroness, Lady Morgan, said, 20% of all medicines would fall within the £20 million cap—these are proven, effective drugs—which makes me think that the cap is far too low. Have the Government assessed the impact of this on patients who have already waited too long for medicines that could benefit them? I am very concerned about patients dying while they wait for NICE to decide to allow them the medicines they need. The current 90-day accessibility obligation is reasonable but is to be increased to three years and, given all the delays in the application process and 12 weeks for consultation, it could easily turn out to be four years.
It is the most innovative medicines that would have reached the new price threshold if it had been in place in the past, and it is those same cutting-edge medicines that will be affected by it in the future. If companies inventing and developing these medicines cannot find a market in this country of a size to make it worth licensing them here, they will just go to other markets and UK patients will lose out.
This is yet another example of rationing in the NHS, and we are getting to the point where patients’ rights under the NHS constitution are being breached. But instead of being honest about it and having a national debate about what should be funded, the Government are hiding behind NICE and restricting its freedoms. Only this morning we heard about banning prescriptions for gluten-free foods and other medicines, which will affect the poor and vulnerable, who normally get free prescriptions. This is arbitrary rationing.
The UK currently gets a disproportionate amount of the EU’s R&D and clinical trials, and Brexit threatens that. I agree with every word my noble friend Lord Sharkey said but, since I have said the same words myself in your Lordships’ House at least five times since last June, I will not bore your Lordships by repeating it. He expressed it much better than I could, anyway. But is this really the time to be putting in place further deterrents to companies making cutting-edge medicines available here? The industrial strategy said a lot of the right things about the Government’s intention to promote scientific research, yet their actions do not match their words.
So I ask the Minister: how soon does the DoH plan to assess the impact of the new NICE cap? I have heard that the Government plan to leave it for three years, which is far too long. I suggest that an impact assessment should be carried out on the first five medicines affected to ensure that the impact on patients is no greater than the Government predict. Will the Minister agree to do that?