1. What steps he is taking to work with clinicians and patient groups in the design of the cancer drugs fund. (13147)

We are committed to ensuring that the cancer drugs fund, which is to be introduced in April next year, will enable NHS patients to have greater access to new cancer drugs. We will soon consult the public and clinicians on our plans for this. From 1 October this year, as an interim measure, regional panels led by expert clinicians will respond to requests to fund cancer drugs that have not been funded locally.

I am delighted with the answer from the Secretary of State. Some people are concerned about the possibility of a postcode lottery. Has the Department thought about that, and what actions does it plan to avoid the fund being subject to that?

I am grateful to my hon. Friend. Many people are concerned about their experience of a postcode lottery and access to new cancer drugs. Indeed, there is not just a postcode lottery but an international lottery, with patients in this country not getting access through the NHS to new cancer drugs while patients in other countries do get access to those drugs in the same clinical circumstances. That is why we will not only establish the cancer drugs fund next year, but, this year, we have found £50 million by making savings on management and marketing costs to enable new cancer drugs to be made available, at a regional level across England, where they are not funded locally.

Has the Secretary of State had any discussions with the National Institute for Health and Clinical Excellence about the fund, and is it cash-limited?

Yes, I did have discussions with NICE. The interim measure this year is indeed cash-limited—£50 million is available between October and the end of March.

Will the Secretary of State consider seriously the situation with regard to Avastin—a drug that particularly relates to bowel cancer? I have a constituent who is dying of that complaint, and their primary care trust has refused treatment under current NICE guidance. NICE is currently reviewing the situation. I would be grateful if the Secretary of State will say that he will support positive findings.

My colleagues and I are very well aware of the issues relating to Avastin, and I am grateful to my hon. Friend for her question. In terms of the interim measure that starts on 1 October, patients should go through all the normal procedures of seeking treatment through their hospital with the consent of their PCT. However, if that fails, a regional panel of expert clinicians will be able to look at their circumstances, with a special fund to enable patients to have access to cancer drugs which previously they would not have received.

Of course we support efforts to ensure that those with rarer cancers get access to the drugs that they need, but there are serious concerns about the cancer drugs fund. Professor Alan Maynard says that

“this will run a coach and horses through the work done by NICE”.

The Lancet has called the fund a product of political opportunism and intellectual incoherence leading to the potential for a postcode lottery between strategic health authorities. Where does this leave NICE—an organisation that the Secretary of State said that he wants to strengthen?

It in no way undermines the role of NICE, which continues to play a very important role in giving advice to the NHS on the relative clinical effectiveness and cost-effectiveness of drugs. However, there are many circumstances at the moment whereby patients are not getting access to medicines. NICE, through its thresholds, is setting limitations on access to new cancer medicines. The hon. Lady should know, because the research was commissioned under her Government, that we need to look at international variations in drug use across health economies. Her Government did not publish that information; we have published it. It demonstrates that in this country we have relatively poor access to new cancer medicines, often before the point at which NICE has undertaken a full cost-effectiveness appraisal. We are going to ensure that patients in this country do not lose out as a consequence of those delays.

When considering the drugs fund, will the Secretary of State bear it in mind that many patients who have had chemotherapy find relief from using herbal medicine and acupuncture? When will he come forward with proposals to interface with next year’s European directive so that herbal and acupuncture practitioners can conform to the law?

I know that the Secretary of State’s response will relate to the cancer drugs fund.

The answer to my hon. Friend’s question is soon.

We are grateful.