2. What assessment has the Minister made of the number of people who will be affected by the Welsh NHS’s decision to follow the approach taken by the NHS in England and remove items that have been deemed as of low clinical priority from the list of prescribable treatments? OAQ54374

NHS Wales has not taken the approach the Member refers to. The All Wales Medicines Strategy Group has developed guidance identifying several treatments that are poor value for money, ineffective or dangerous. Doctors use their clinical judgment and other prescribers to offer the best possible treatment options to their patients.

Thank you for that answer, Minister. Welsh eight-year-old Sofia Bow was born with the genetic disorder cystic fibrosis, which affects one in every 2,500 babies born. This Government has refused to fund the drugs Orkambi and Symkevi, even though they have been proven to improve lung health and reduce the need for hospital admissions, saying they're too expensive, while the Scottish Government has managed to negotiate a discount with the manufacturers so that the drugs can be prescribed to sufferers in Scotland. Sofia’s family are considering leaving their Welsh home to move to Scotland so that their daughter can get the life-changing treatment she needs. So, will you now copy the Scottish NHS in prescribing Orkambi and Symkevi? If it is just down to the money, once you've worked out a reasonable price for a child’s life, will you arrange a discount if required, or do you need the Scottish health Minister to do it for you?

I'm afraid the Member's question doesn't just depart from her initial one in not referring to low clinical priority treatments and a list of prescribable treatments, but actually it's a significant misunderstanding of the position around Orkambi.

I have said in correspondence to all Members and in public statements that I continue to express my frustration at the choice that Vertex have made—the manufacturers of Orkambi and Symkevi—to not engage with the appraisal process here in Wales. It's not simply a matter of money. Members here, but also those watching families who are directly affected, this is not simply about money; it is actually about the refusal to engage in a process to provide the clinical evidence of the effectiveness or otherwise of these medicines. Frankly, if they were making the medicines available for £1 a go, as opposed to £100,000 a treatment, we'd still need to know what is the effect of the medicine.

On the deal that they've struck in Scotland, having had their own Scottish appraisal process not grant access to Orkambi, they've then gone back and struck a different deal. That's in commercial confidence. I have not had sight of that, so I'm not in a position to copy the same deal or even to comment properly on the relative value provided to it.

I'd say again to Vertex to engage with the appraisal process here in Wales as they have indicated in the past they would do, to not place families in this invidious position, and to allow us to properly understand the effectiveness of the medication that they have available, and for us then to make a properly evidence-based choice. I don't want any family in Wales to be put in the position that the Member describes because of a refusal of a pharmaceutical company to engage in our well-respected and well-understood appraisal process.

Minister, I welcome the approach that's been taken by the Welsh Government to the prudent healthcare agenda. One of the principles of that agenda is, 'Only do what you can do and let others do things that you cannot do.' Of course, one of the ways that the NHS could be reformed would be to enable pharmacists across Wales to do more of what is currently being done in GP surgeries. Today is World Pharmacists Day, what do you have to say to those pharmacists across Wales who are looking for a new contract in order that they can deal specifically with this issue once and for all?

As I've indicated previously when discussing primary care more generally here, the reform process of contracts in primary care, including pharmacy, is an important part of our ability to meet our shared objectives. Actually, pharmacy contractors here in Wales who are community pharmacists are engaged in a regular and constructive conversation with the Government. I expect the next stage of the future pharmacy contract to allow us to invest more in the future of pharmacy and in a wider range of services, some of which, you never know, may form part of the questions that other Members will ask later on the order paper.