Lariam

Part of the debate – in Westminster Hall at 4:16 pm on 27th October 2016.

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Photo of Kirsten Oswald Kirsten Oswald Shadow SNP Spokesperson (Armed Forces and Veterans) 4:16 pm, 27th October 2016

It is a pleasure to serve under your chairship, Mr Rosindell. I am aware that we are now very short of time, so I shall look for your guidance on when you want me to stop speaking so that the Minister can respond.

I thank Mrs Moon for opening the debate so thoughtfully, and the Defence Committee for its work. I endorse its recommendation that Lariam be retained for use by the Defence Medical Services, but it should be a drug of last resort, subject to the clear recommendations set out by the Committee. I would go further and suggest that those who are prescribed Lariam should be counselled about the potential side effects and the need to report them up the chain of command.

Once I had reviewed the Select Committee’s report, I was left wondering whether the level of debate and conflict on this issue was actually necessary—I shall try to return to that point at the end. I noticed from the departmental memorandum submitted to the Committee that the Ministry of Defence policy on preventing malaria is contained in a joint services leaflet called “Preventing Malaria in Military Populations”. I understand that the leaflet was made available to the Committee, but when I looked on the Government website, it was not there—it was released under a freedom of information request in 2013, so I was able to see it that way. The covering letter attached states that, in the interests of transparency, it should be published online. Had that happened and we had been able to see it, it would have been useful to a number of people. The sole reference in the leaflet to the use of Lariam and other antimalarial drugs is the statement:

“In the UK Armed Forces…policy is based on the guidelines at Footnote 1”,

which helpfully read:

British National Formulary (BNF). BMJ Group and Pharmaceutical Press Extant Version”.

As we have heard from several Members in the debate, information on the use of Lariam is sorely lacking. The only direct reference to it in the guidance was regarding its use by divers and aircrew, who are not to use it. There is considerably less information than I would have expected from a document that is described to Members of this House as the Government’s policy on the use of antimalarial drugs. It is exactly as my hon. Friend Douglas Chapman said.

Had the information been freely available, we would have seen a description of the briefing that is given to personnel receiving antimalarial drugs without an individual consultation. The only definitive items that have to be included in that consultation are dosage and frequency, and when to start and finish taking the drug. If that is the situation, advice levels clearly fall far short of what we would expect, as Dr Lewis said. There was simply no indication that Lariam should be regarded as any different from other antimalarial drugs.

Will the Minister address whether the document was published online? Will he tell us more about the advice the Government are seeking from Public Health England’s Advisory Committee on Malaria Prevention? Will he commit to a wider consultation on the version of the guidance that is currently being prepared? I also wonder whether he will commit to review the procedures for sharing and consulting on policy documents, which are so vital to the welfare of our armed services personnel, as Johnny Mercer told us.

The Government response looks too much like business as usual. The Committee’s report outlined the three stages when a risk assessment should be carried out: on completion of initial training; on being posted to a deployable role; and on receiving warning of possible deployment. Will the Minister clarify how the assessments will be made? Are they additional assessments, in which case how do we know what resources are needed to deliver them and are those resources in place?

As we heard from Jeremy Lefroy, the evidence provided by the Department in its response to the Committee reveals a significant difference in the nature of the side effects caused by Lariam and those caused by alternative drugs. We have heard significant detail about that difference today. As the right hon. Member for New Forest East said, the evidence that Lariam has such a clear link with adverse psychoactive effects suggests that the Committee’s recommendations about the use of the drug should be clearly heard by the Government, and it should simply be a drug of last resort.