Part of the debate – in the Senedd at 3:46 pm on 27 September 2016.
Thank you for the questions. I want to begin by welcoming the constructive conversation, both with Rhun and with other opposition health spokespeople, up to this point, on the terms of reference of the review. I hope that other opposition spokespeople found it useful to meet Mr Blakeman as the chair of the review group. I think we have an excellent appointment, not just of the chair, but of the whole group. I look forward to receiving their work.
Just a point on Irfon Williams and the patient voice. We wanted to make sure that membership reflected that for the review group, but equally—to be really clear—this isn’t just that Irfon Williams is on the group, and therefore the patient voice is sorted. There is a recognition that, in the way that they conduct the evidence, and the way that they listen to people, they need to talk to both the wider third sector and with a range of campaign groups who can help to give a patient’s perspective, but equally to look directly to some patients who have been through the process—both those who have had successful applications, but equally to those who have not as well. It’s important that they get some direct experience from a wider group of people. I’m pleased to see that that is going to be taken on board in the way that they conduct their work.
On the new treatment fund, as you’re aware, it’s a manifesto pledge that is being implemented. I will update Assembly Members on the detail of how we expect that to work, and the criterion that will be used. When it comes to the attitude of this Government, if health boards take the money but don’t want to ensure that access is provided, well, then they won’t get the money. It’s very simple. The money will be provided for particular drugs to be made available, and we expect them to be made available. The whole point about this is to make sure that there is an evidence base for the effectiveness of medication, to make sure that, once there is approval for them, within a limited period of time, it is available consistently across Wales. Because we recognise that there is, sometimes, an inequity in having medications available in different health boards and the way they are able to manage their position. It’s also important to make sure that that innovation and that evidence base is available on an equitable basis across the country. I think, when we get to announcing how the fund will work—the practical detail of it, and its implementation by the end of this year—I think a range of the questions you have will be satisfied.
On the point about ‘maybe’ drugs, there’s a challenge in England about looking at the cancer drugs fund, which has come to an end after fairly universal criticism, at the end of it, about its value for money and the equity that it provided. The Public Accounts Committee in the House of Commons said that there was no evidence of improved patient outcomes. Well, there’s a different approach that they’re looking to take, but there’s still a challenge of working that through practically, because with the idea of having a ‘maybe’ category, or a ‘promising’ category of drugs, NICE need to be able to work through and understand what that is. There has to be some clarity around that so that NICE understand what they’re working to, and equally, then, the public. To be fair, the industry that will want to come to NICE for appraisals of new medicines need to understand what their category might mean as well. As there is clarity around that, we need to then understand what we want to do here in Wales as well, rather than inventing a new category ourselves. I don’t think that that’s very helpful. What I will say is that, just as with the cancer drugs fund, we took, I think, the principled and correct view that it was unethical to say that cancer patients—that their lives were of greater value than other patients in the national health service and in this country. We will not proceed down the route of wanting to advantage a particular cohort of conditions. It must be a properly equitable access to new and innovative medication and we want to be able to make sure that there is a proper evidence base for that. That will continue to be the approach that this Government takes.