Dozens of MPs are opposing Wes Streeting’s decision to award himself power to dictate what the NHS pays for drugs amid growing concern the move may be illegal.
Thirty-one MPs have signed a House of Commons motion voicing their disapproval of the health secretary being handed the power to override the National Institute for Health and Care Excellence’s (Nice) judgment on how much the NHS should spend on individual medicines.
They fear that the change is a “power grab” that undermines the role Nice has played since its creation in 1999 as the arbiter of which medicines constitute value for money for the NHS to buy – and thus which patients can receive – in England and Wales. Nice is widely viewed internationally as a model of how to protect against drug companies charging excessive prices.
Labour, Green, Liberal Democrat, Independent, Scottish Nationalist and Plaid Cymru MPs have backed a “prayer”, tabled by the Labour ex-shadow chancellor John McDonnell. MPs can use a “prayer” as a way of showing they disagree with a statutory instrument – secondary legislation or regulations, which they do not vote on – the government is using to implement a change of policy it has decided on.
A statutory instrument recently gave Streeting the power to “direct Nice as to the applicable cost-effectiveness threshold to apply to a health technology undergoing appraisal” as part of the government’s drug-pricing deal with Donald Trump’s administration.
McDonnell said: “One of the express purposes of establishing Nice was to insulate the NHS from the powerful and well-resourced lobbying of the pharmaceutical industry.
“The changes the government are making to Nice as a result of the US pharmaceutical deal undermine the independence of Nice giving US big pharma the potential of immense influence over our drugs policies.
“This risks precious NHS resources being diverted away from life-saving practices and handed to drug companies instead, to the harm of patients.”
Helen Morgan, the Lib Dem health spokesperson, said Streeting had been given the power to direct Nice because Keir Starmer, the prime minister, had caved in to “the bully in the White House”.
She said: “This change to Nice rules is clearly coming at the behest of Trump, not because the government thinks it will help patients.”
Ministers have defended the deal as a way of helping British drug exports to the US avoid tariffs, and giving patients access to potentially life-extending drugs that would otherwise be denied.
The MPs have been joined in their concern by an unlikely ally: Andrew Lansley, the Conservative ex-health secretary, who is now a peer. He has tabled a “motion of regret” in the House of Lords warning that the regulations risk undermining Nice’s independence and also appear to be incompatible with the Health and Social Care Act 2012, “which provides that a direction by the secretary of state must not relate to the substance of recommendations by Nice”.
Meanwhile, the overall UK/US deal has caused growing alarm among health experts. The Health Foundation thinktank has warned that higher NHS spending on drugs will force it to make “difficult cuts” to other services that improve patients’ health more cheaply.
The economist Eric Yang said in a recent blog: “Given worsening funding pressures from higher demand and demographic changes, the NHS can ill afford to sacrifice resources for a higher drugs bill in the short term. Spending the NHS budget has always involved making difficult trade-offs, but the UK-US drug-pricing deal means trade-offs will now be even more difficult in the future.”
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