Speaker Lunch at the House of Commons

Around a hundred industry people got the inside track on the workings of the Parliamentary Health Select Committee at the annual PM Society House of Commons lunch on 17th October. Committee member and MP for Bristol North West Doug Naysmith, who has himself worked in the pharma industry, told the gathering that a period of change was in the offing - although he said that that change would not necessarily be "dramatic"

Dr Doug Naysmith, MP for Bristol North West and Member of the Parliamentary Health Select Committee

Dr Naysmith, who worked for Beechams before becoming an MP, explained that the HSC was one of the most popular committees to sit on, especially amongst Labour MPs. He first applied to sit on the HSC after Labour took power in 1997, but was one of 71 members vying for the four places available.

After the 2001 election, he was successful, and became one of the 11 members of the committee, the political make-up of which is determined by the election result. In the last session, there were seven Labour members, two Conservatives, one Liberal Democrat, and one independent, the consultant Dr Richard Taylor.

Dr Naysmith said that parliamentary committees have quite a lot of power, despite - or perhaps because of - the fact that they are not part of the executive. They carry out investigations which can be quite wide-ranging, and few people refuse an invitation to give evidence.

Despite the cross-party make-up of the HSC, it very rarely needs to vote on issues, as the reports it produces are generally agreed by consensus. Like all parliamentary committees, it makes recommendations to the Government, which, according to Dr Naysmith, often says "good idea" - and then goes on to explain why it can't implement the recommendations!

He then turned to the recently published committee report on the pharmaceutical industry, the hot topic of the moment. The report makes 48 recommendations, and although it recognises the huge contribution that the pharma industry has made in improving quality of life, reducing surgical intervention and saving lives, it also, according to Dr Naysmith, "reflects the suspicion of scientists and big science in the population at large - which is also shared by many MPs."

"The report criticises practices within the industry which are difficult to defend," said Dr Naysmith. "The industry has a bad name, which is a shame given the achievements it has made over the years. But there is a place for criticism."

Dr Naysmith explained that the committee found that priorities for research projects are being set in the interest of the drug companies and not that of patients, citing the proliferation of 'me-too' drugs as an example. He added that the industry concentrates (not surprisingly) on pharmaceutical products rather than developing non-drug therapies.

The report also calls for more transparency in clinical trials, and claims that aggressive promotion at launch can cause confusion for prescribers. Dr Naysmith called for a more structured education process for prescribers - not just advertising.

He also called into question the effectiveness of the current yellow card scheme for reporting adverse drug reactions, saying that patient reporting of ADRs should be made easier.

The final area he outlined from the committee's report was that of so-called disease-mongering. Although the restrictions on direct-to-consumer communication are likely to stay, he said that regulation of disease awareness campaigns was "weak".

He finished his presentation by saying that the Government largely agrees with the conclusions of the report, and that openness around clinical trials was likely to be the priority area. "Following this report, the industry is facing a period of change. It won't necessarily be dramatic change, but it will be wide-ranging and long-lasting," he said.

In a wide-ranging question session, there was a concentration on how pharmaceutical companies can achieve return on investment on big research projects in an environment of increasing restrictions and tighter pricing controls. Questioners repeatedly made the point that for the industry to undertake a different focus in research required a commitment from the Government that its reimbursement policy would make such investment worthwhile.

Dr Naysmith said that the industry has to convince the general public of the value for money given in return for the taxpayers' money which is paid to it. He said that there is a political will to change, and asked (but didn't answer his own question) why the industry should not follow.

Asked about the take-up of new medicines across the NHS, Dr Naysmith berated the lack of consistency, saying that there are some examples of great practice, and some which were "rubbish". He claimed that this is not due to financial reasons, and is more likely to be about inefficient management and lack of leadership locally.

He criticised NICE, saying it was not as fast as it could be, conceding that it is probably not financed well enough. "We recognise that the process is slower than it should be, and we are looking for a fast-track process," he said.

Questioned about the availability of drug information from outside the UK on the internet, Dr Naysmith said that while he held no strong views on DTC advertising, he did sound a note of caution about information from the net. He linked the subject to that of providing more open clinical trial data.

Dr Naysmith finished by outlining the next three reports which the HSC is to undertake: a White Paper on smoking, a report on co-payments (including prescription charges), and a look at changes in PCTs and Strategic Health Authorities.

He praised the PM Society and reinforced the need for an educational network that could discuss topical issues and share best practice, saying, "When I look at the aims of the PM Society, I am very impressed. I urge you to carry on the work that you are doing."

Held on: 17/10/2005