Asked by
Baroness Taylor of Stevenage
To ask His Majesty’s Government what steps they are taking to
address reported shortages of supplies of antibiotics, given the
increase in cases of Streptococcus A.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
We are working at pace with manufacturers and wholesalers to
expedite deliveries, bring forward stock and boost supply. UKHSA
and the NHS are co-ordinating communication to healthcare
professionals, including advice on using alternative effective
medicines as necessary to ease pressure on supply. Early
treatment is vital, so in addition to bolstering supply we are
providing information to parents to understand the trigger points
for urgent referrals.
Baroness Taylor of Stevenage (Lab)
I thank the noble Lord for his Answer, but despite Ministers
saying that there is no problem—the Health Secretary has said
that—worried parents across the country are going from pharmacy
to pharmacy to seek the antibiotics their children need. Can the
Minister update your Lordships’ House on the improvements in
availability since the Health Secretary said, as in the statement
repeated this morning, that he was
“working urgently with manufacturers and wholesalers to explore
what can be done to expedite deliveries”?
Further, are there any plans within DHSC to update the
concessionary price for amoxycillin and penicillin, so that
pharmacies do not have to foot the bill for the rapid increase in
costs they are experiencing?
(Con)
I thank the noble Baroness for bringing this important matter to
us all. Yes, they are working very strongly; I had a series of
meetings yesterday on this very subject to go through all they
are doing on the supply front. Importantly, as we speak, they are
putting out advice to medics about suitable alternative
antibiotics that can also be used in this case. I am satisfied
that they are doing everything they can towards this. Clearly,
where there are price problems such as those the noble Baroness
mentions, we will also act in that area.
(Lab)
My Lords, the cost of producing strep A antibiotics has not
changed but the selling price has rocketed in recent weeks from
80 pence to £19 per packet, mainly because of profiteering by
companies. Will the Minister launch a publicly owned company to
manufacture generic drugs, which would provide jobs and exports,
secure long-term supplies, protect the NHS budget and end the
profiteering by drug companies? Does he have any objections to
that?
(Con)
My general thinking—this is a personal view—is that the market is
normally very well placed to supply these things. There was the
excellent example of the vaccines, whereby it acted incredibly
quickly and got Covid vaccines out as necessary. I think we are
always better placed using the strength of the whole market and
looking to international suppliers as well. They are always going
to be able to provide the necessary medicine to a quicker
timescale than our own company would.
(CB)
My Lords, since the risk of invasive group A streptococcal
infection is increased in the presence of other viral
infections—any of them; it could even be chickenpox in
children—what guidance are the Government giving to all schools
on public health measures to decrease cross-infection between
children and ensure parents are encouraged to keep those who
might be unwell away from school, rather than sending them to
school, as is the tendency, because of attendance registers?
(Con)
The noble Baroness is correct; it is the coincidence of more than
one condition, particularly respiratory conditions, which causes
the more extreme cases. The advice is definitely to keep children
away from school if there is any question on that at all,
especially as we are about to enter a period of school holidays.
It is very much the view of the experts that the school holidays
should flatten the curve of infections. I should also say at this
point that while we are all quite correctly concerned about this,
and doing everything we can regarding supply, the current levels
are still lower than those we saw in 2017-18, when March and
April had the normal peaks of around 2,000 a week. We are
currently at around 1,200 cases a week and, as I say, we expect
that to flatten out a bit with the firebreak, so to speak, of the
Christmas holidays.
The Lord Speaker ()
My Lords, the noble Lord, , is participating
remotely.
(Lab) [V]
My Lords, as someone on a six-day lockdown and on intermittent
antibiotics to deal with a lung condition following surgery, can
I suggest, on these shortages, that guidance on antibiotics such
as amoxicillin should be updated to allow for greater flexibility
of expiry dates? There is too much wastage, and with careful
prescription advice and labelling, antibiotics can have a far
longer shelf life before deteriorating. Rigid advice on packaging
should be relaxed in favour of more flexible expiry dates, as
current advice only serves the manufacturers, who sell more.
(Con)
I thank the noble Lord and I agree. We are looking at every
sensible measure we can to ensure we have the greatest
flexibility of supply. Expiry dates are clearly one thing we can
look at, and I will take that back to the department. I wish the
noble Lord well and hope that he feels better soon.
(LD)
My Lords, community pharmacies in Northern Ireland were warning
back in October of serious problems with the supply and pricing
of a range of drugs. While it is welcome that there now appear to
be investigations into the wholesale supply chain for
antibiotics, may I also urge the Minister to look at whether
there were missed opportunities for earlier intervention?
(Con)
Absolutely—clearly, we always need to learn in such
circumstances, so we will be happy to do that.
(Con)
My Lords, I remind the House of my interest with the Dispensing
Doctors’ Association. Can my noble friend give reassurance that
dispensing doctors, pharmacists and others will be reimbursed for
the full cost of the increased price of antibiotics?
(Con)
My understanding is that there are measures in place to ensure
that the people supplying in those circumstances are not losing
out because of profiteering. The most essential message today is
that that supply is available to anyone who needs it, so I will
take that back.
(Lab)
My Lords, is it the manufacturers in the pharmaceutical industry
or the wholesalers—the middlemen—who are making the profits? What
mechanisms are available to clamp down on them?
(Con)
The key mechanisms always involve broadening the supply chain. I
have given exactly that instruction to the department, which is
very much taking it on board. It is looking at supply across a
number of sources, not just from the UK but worldwide, as well as
the substitution of antibiotics. Penicillin is currently the
advised one, but a number of others are being advised right now
which will also work well, so that there is as much choice as
possible.
(Con)
My Lords, my noble friend will be aware that, while some people
are making profits, 16 children under the age of 15 have died as
a result of strep A. Exactly what advice is being given to GPs so
that parents have direct access to them very quickly? Of course,
there is also a concern about antibacterial resistance as a
result of overprescribing antibiotics.
(Con)
I thank my noble friend and will take this opportunity to offer
that public health advice. A rash, which is often the first sign
of a bacterial infection in this case, or a child being floppy,
drowsy or dehydrated are all key signs that they should urgently
seek medical help. People can call 111 or 999 and be guided
through the triaging process to make sure that they get help
quickly. At the same time, medics have been told to lower the
barrier for prescribing, so to speak, so that they can make sure
that people get it early. Although every death is a tragedy, we
are clearly now seeing some reduction in the death rate, which is
welcome.
(Lab)
My Lords, while many pharmacies are being forced to sell the
antibiotics they can get their hands on at a considerable loss,
as wholesale prices soar, the Government have been saying that no
company should be using this as an opportunity to exploit the
NHS. Can the Minister assure the House that the Government have
learned from previous mistakes with procurement and are taking
measures to ensure that no company profits unduly from the
increased demand for medication?
(Con)
As I mentioned, no one wants to see profiteering in these sorts
of situations. The absolute focus right now is on expanding
supply, because that is clearly the first thing you need to do.
But you then absolutely need to learn lessons and see that
appropriate action is taken against companies doing that.
