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House of Lords

Wednesday, 6th February 2002.

The House met at half-past two of the clock: The LORD CHANCELLOR on the Woolsack.

Prayers—Read by the Lord Bishop of Blackburn.

Haemophiliacs: Recombinant Treatment

Lord Morris of Manchester: My Lords, I beg leave to ask the Question standing in my name on the Order Paper. I have an interest to declare, but not a financial one, as president of the Haemophilia Society.

The Question was as follows:

    To ask Her Majesty's Government when they now expect to provide recombinant treatment for people with haemophilia irrespective of age or where they live in the United Kingdom.

The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath): My Lords, the Government are considering the case for extending the provision of recombinant clotting factors to all haemophilia patients in England.

Lord Morris of Manchester: My Lords, is it not cruelly wrong in principle that people with the same disability are given or refused safer medical treatment according to whether they live in Scotland and Wales or in England? And more especially so when contaminated blood products that were prescribed for them have already taken the lives of over 1,000 haemophiliacs in the NHS's worst-ever treatment disaster. Is it not also plainly wrong that even the current policy of entitling children in England to the safer recombinant treatment is sometimes ignored? What have Ministers done to protect such vulnerable children? When will right be done?

Lord Hunt of Kings Heath: My Lords, I acknowledge the force with which my noble friend and the Haemophilia Society have put forward the case over recent years. There is no evidence that recombinant clotting factors are more efficacious than plasma-based products. My noble friend is certainly right to suggest that policy varies in different parts of the United Kingdom, with Scotland and Wales committed to providing recombinant treatment for all haemophilia patients. As I said, we very much understand the concerns of the people who have been so tragically affected, and we are considering the position in England.

Baroness Gardner of Parkes: My Lords, is the Minister aware that patients with haemophilia are experiencing great difficulty in obtaining dental treatment? When those patients have been refused and have taken up the matter with the United Kingdom Haemophilia Centre Doctors Organisation, they have

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been told that the matter should be referred to the CJD Incident Panel. Is that because they are being treated with non-recombinant factor or would all haemophilia cases be so referred, and why are such referrals made to the variant CJD treatment centre?

Lord Hunt of Kings Heath: My Lords, I believe that the reference to variant CJD has come about because consultation on risk assessment in relation to the use of medical instruments has just concluded. However, I shall be happy to follow up this matter with the noble Baroness. If she has specific cases to bring to my attention, I shall certainly be prepared to look into them. In relation to access to dental treatment, I would also expect community dental services at local level to be asked to look into matters which affect people locally.

Lord Addington: My Lords, does the Minister agree that this matter concerns the basic safety of the treatment? As recombinant treatment is seen to be safer and more efficient, is it not the case that a group who historically have suffered so badly should receive that treatment straightaway?

Lord Hunt of Kings Heath: My Lords, I hear what the noble Lord says. As I said, the matter is being considered carefully by the Government at present. However, the advice that I have received is that there is no evidence that recombinant clotting factors are more efficacious than plasma-based products. But, of course, I recognise the feelings of those in the community and the fears of parents of children and, indeed, of all those who receive blood products through infectious agents. That is why the Government are considering the matter.

Baroness Masham of Ilton: My Lords, I also declare an interest as a vice-president of the Haemophilia Society. Is the Minister aware that in Newcastle upon Tyne 75 per cent of haemophiliacs have contracted HIV? In addition, bearing in mind the problems of CJD and hepatitis C, is it not time that haemophiliacs were given the safest possible form of clotting agents?

Lord Hunt of Kings Heath: My Lords, I do not believe that I can add to the response that I gave to the noble Lord. As I said, the advice that I have received is that as yet there is no evidence to suggest that there is an issue of safety between the different products. We understand the feelings of those in the community who are involved and affected by the tragic events that have occurred. We are obviously considering the matter.

Lord Turnberg: My Lords, if it is now possible for the manufacturers of recombinant factor 8 to produce a sufficient amount of the treatment for everyone who might need it, is there now any reason why that material should not be available to all haemophiliacs, regardless of age?

Lord Hunt of Kings Heath: My Lords, my noble friend is right in identifying that a shortage of

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recombinant factor 8 has limited supplies to the UK over the past year. My understanding is that that shortage has now eased up and that manufacturers have increased production. Obviously that is one of a number of issues that needs to be taken into account.

Lord Clement-Jones: My Lords, if the Minister and his colleagues are prepared to consider beta interferon for MS sufferers, why should the Government not enter into a novel risk-sharing arrangement over recombinant clotting factors as they have done in relation to beta interferon?

Lord Hunt of Kings Heath: My Lords, that is certainly an interesting suggestion. I would say only that at present these matters are under consideration by the Government.

Lord Morris of Manchester: My Lords, further to my noble friend's reply to the noble Baroness, Lady Gardner, can he tell the House how many people with haemophilia have received blood that was donated by donors who have since died of variant CJD?

Lord Hunt of Kings Heath: My Lords, the figures so far are that eight people with variant CJD are known to have been blood donors and 22 people have been identified as having received transfused blood from donors who later developed variant CJD. I understand that the total number of deaths from variant CJD is 106.

Earl Howe: My Lords, have the Government estimated the additional cost of recombinant treatment to haemophiliacs were it to be available in England?

Lord Hunt of Kings Heath: My Lords, the cost that has been made available to me is in the region of £50 million a year.

Foot and Mouth Disease: Contingency Planning

2.43 p.m.

The Countess of Mar asked Her Majesty's Government:

    Whether they have fully implemented the European Union Foot-and-Mouth Disease Contingency Plans for Great Britain (last revised in July 2000) and, if so, when this took place.

The Parliamentary Under-Secretary of State, Department for Environment, Food and Rural Affairs (Lord Whitty): My Lords, the contingency plan provided a general overview of our planned response to an outbreak and was approved by the European Commission. It was a strategic plan supported by detailed operational guidance and veterinary instructions. An interim contingency plan is now being

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prepared based on recent disease experience and current policy and it will build on existing relationships between interested parties. It codifies the operational regime developed during the recent outbreak and since, and will complement the existing strategic framework and the detailed instructions.

The Countess of Mar: My Lords, I am puzzled. The Minister has not answered my question. I asked whether the contingency plan has been implemented and, if so, when. I have the impression that it never was implemented. Am I correct?

Lord Whitty: No, my Lords. The noble Countess should listen more carefully. I indicated that the contingency plan provided the general overview by which we responded to the disease. I have told the House before that part of the problem with the original contingency plan was that we assumed that we were faced with a new outbreak, whereas in fact the outbreak had been spreading for some considerable time due to the trading patterns within the industry at that time. Nevertheless, it provided the strategic overview that we followed. Therefore, it was implemented in line with what we had told the European Commission. Since then, in some respects we have had experience of the shortcomings of that plan, although the bulk of it still stands. We are learning those lessons and we are now drawing up a new contingency plan.

Baroness Byford: My Lords, I am slightly surprised by the noble Lord, Lord Whitty, being "smidgy"—sharp—to the noble Countess, Lady Mar, as he did not answer her Question. The guidance clearly states that the person in charge should be the chief vet. Can the Minister confirm that, at the beginning of the outbreak, the chief vet was in charge but was removed, that the chief scientist then took charge and was removed, and that the Prime Minister then took charge and everything went wrong?


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