Health and Sport Committee, 23 Jan 2008

Meeting date: Wednesday, January 23, 2008

Official Report 276KB pdf

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Petition

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Cancer Treatment (Cetuximab) (PE1108)

Item 3 deals with an important petition. I refer members to paper HS/S3/08/3/2.

As with all petitions, this one raises some general issues and it is those that are important, rather than the specific example.

The petition gives us an opportunity to use the reporter system, if we can find a volunteer to be a reporter—that would not be me. When I was on the Health and Community Care Committee in the first Parliament, I did three reports. The reporter system offers an effective and less time-consuming way of elucidating the principles that are involved in the important issue that is raised by the petition. Perhaps my colleague Dr McKee would be a suitable reporter.

Ah, you are volunteering Dr McKee.

For clarity, I should say that the petition has not yet been formally referred to the committee.

That is right; we are being asked for our opinion on it.

Yes. I call Michael Matheson, to be followed by Mary Matheson—I mean Mary Scanlon. [Laughter.]

Obviously, she has become my auntie. My auntie Mary, in the committee!

I think that that was unkind—to be referred to as auntie. At least it was not grannie, I suppose.

Given that time is of the essence in relation to this petition and that it will be difficult for this committee to find the space any time soon to give this matter the consideration that it is due, I would be satisfied if the Public Petitions Committee were to undertake its own inquiry into the matter, if there were a willing volunteer from our committee to act as a reporter who could attend that committee and report back to us. However, I do not think that we should do anything that might delay consideration of the issue.

Mary, do you have a different view?

I apologise for not finding this out before the meeting, but I would like to know whether the drug that is referred to in the petition has been appraised and recommended by the Scottish medicines consortium.

I cannot answer that.

My understanding is that it cannot have been because, if the SMC had approved the drug, health boards would have been obliged to fund its use.

I am advised that that is indeed the case.

I am on the Public Petitions Committee and listened to the evidence that was given on the petition. It was moving and quite sad to hear about the human cost of the decision.

I understand that the drug is available in other health board areas. However, the petitioner's husband had to fund his own drug treatment, which meant that he also had to fund treatments that, had he not been taking the drug, would have been funded by the national health service. It was therefore not just the drug that he was funding; it was the whole treatment, including blood tests and the like.

I understand the argument that this committee will struggle to find the time to consider the petition and that we should therefore ask the Public Petitions Committee to go ahead with it. However, big issues arise that relate to our inquiry into health inequalities. With the help of family and friends, this man has been able to raise money, but he made the point—and, given his circumstances, he made it very strongly—that people who did not have access to financial support would be dead already, not having received the drug. He wanted to point out that the system was very unequal. He had access to money, but others did not.

This is not an either/or situation. The committee might want to let the Public Petitions Committee deal with this, and a reporter from this committee could attend its meetings formally, or any of us could simply attend informally. That would not prevent us from taking this gentleman's situation into account when we come to our inquiry into health inequalities.

That is what I meant.

We have to remember that this case is urgent. Would any committee member be prepared to be a reporter? Rhoda, could you fulfil both roles—as a member of the Public Petitions Committee and as a reporter from this committee?

Yes, it would be a formal reporting role.

Right, we will have you there in a formal capacity and you will report back to this committee. We will write to the convener of the Public Petitions Committee accordingly, saying that we want that committee to deal with the petition because of its urgency, and saying that we will consider the issue as part of our wider inquiry into health inequalities. So, we will make three points: the Public Petitions Committee should take the matter forward; Rhoda Grant will be our reporter; and this committee will absorb the petition into our inquiry into health inequalities. A letter in those terms will be sent on behalf of the committee.

I dread to contradict Dr Simpson—I do so with some fear and trepidation—but my reading of the paper that we have received was that the petitioner's concern centred on both the lack of transparency and the different ways in which different health boards deal with recommendations from either the SMC or the National Institute for Health and Clinical Excellence. The inference to be drawn was that, in this case, the drug has been approved, but different health boards in Scotland took different decisions on whether to fund it and/or allow it to be used in their areas.

The Public Petitions Committee could clarify that for us.

That would be important.

I agree. I will include that point in the letter. We are not clear about the status of the approval of the drug in different boards.

My understanding—and I could be wrong, because for four years I have just been working in the field—is that, if the drug is approved by the SMC, the boards are obliged to fund it. Therefore, this issue should not have arisen.

If boards are misinterpreting the situation, that is one matter. It is a different matter if drugs such as this one have been approved—in terms of their European and British licensing arrangements—but have not then gone through the NICE or the SMC process. These questions need clear answers before the Public Petitions Committee can proceed.

In the first instance, we should write the letter to the convener of the Public Petitions Committee, so that the petition can make progress, but we should also ask for a briefing from the Scottish Parliament information centre on the status of the various approvals and the obligations that they place on health boards.

That would be helpful for both committees.

That is now on the record for the benefit of the Public Petitions Committee.

The confusion was that one member of the committee said that the drug had been approved by the SMC but another said that the drug had not been approved. Going back to Rhoda Grant's points, I did not understand whether, if the drug was not approved, some health boards were offering it, perhaps through clinical trials. We have to get the SMC appraisal and then move on from there.

The clerks will refer SPICe to our debate and will ask for clarification on all the points that members have raised. The convener of the Public Petitions Committee will also be aware of our concerns.

Meeting continued in private until 12:36.