Hormone Replacement Therapy Implant — House of Commons, 2015-01-28
Topic: Health
Tracey Elizabeth Anne Crouch (Conservative, Centre-right): I am grateful to the hon. Gentleman for his intervention. The implant is no longer uniformly available nationally. The decisions being taken locally are affecting people who might not be able to travel to London, for example. I shall come to that later in my speech Sarah contacted Medway CCG to ask whether it would object to her being referred to the Chelsea and Westminster hospital as an NHS patient. The CCG told her that there was no objection and that the patient’s well-being was its priority. Following that consultation, Sarah had her first appointment at the Chelsea and Westminster on Monday 12 January this year. She was accompanied by her husband, and he was able to tell the medical practitioner who interviewed Sarah what it had been like before she received HRT implants at the Lordswood clinic, what it had been like after she had the implants, and what it had been like to see her health deteriorate again when that treatment was no longer available. He said: "I just want my happy, healthy Sarah back." The medical practitioner that Sarah saw said she was an ideal candidate for the HRT implant and did not hesitate in giving it to her during that first visit. Within a week Sarah says she is already feeling much better, and she has now set up a website dedicated to supporting women suffering severe menopausal symptoms. I am sure that Sarah is just one woman of many who have found themselves in this predicament, but not all have had such positive outcomes I would like to take this opportunity to thank the constituents of mine, especially Val Weeden, who have tirelessly researched and campaigned on this issue. They have actively searched for solutions and continuously shared their information with me. They have constantly supported each other through what has clearly been a very tough situation for many. It is extremely unlikely that this issue is unique to my constituency; I am sure that many women across the country and beyond who suffer from severe symptoms no longer have access to this potentially life-enhancing treatment because of localised commissioning structures. They may not all come across information for Chelsea and Westminster’s specialised service, and women in the far north or far south of the country who do may struggle to travel to London, at a potentially extortionate cost. Although I appreciate that this is not a cost to be incurred by the health care system, it is one that I would like the Minister to consider today After some research into this issue, I identified that on 5 July 2011 MSD, the only licensed provider of the Estradiol implant here in the UK, issued a letter to GPs stating that it was to cease manufacture of the product. It stated: "the company’s global decision to discontinue the manufacturing of Estradiol was made after consideration of commercial factors and the fact that therapeutic alternatives are available in most countries. The decision is not related to a product quality or safety issue" For most women, this issue of cost has no impact on their treatment and well-being, but the 200 women in my constituency, and, I imagine, many others beyond for whom the alternative forms of HRT are not suitable, have been left with a void in their health care. The UK now has no licensed provider for a treatment that enables sufferers to live a normal, high-quality, day-to-day existence I recognise that the lack of a licensed provider is not necessarily a problem, as GPs are able to prescribe unlicensed medicines if they feel there is a special need and an unlicensed provider of the product exists in the UK. However, in my constituency this process has not adequately represented the women for whom this treatment is so important, because when our CCG made the announcement in March 2014 that it would no longer be providing funding, the justification was that 200 women was far too great a number to be treated with an unlicensed medicine when licensed alternatives were available Although I disagree with the idea that an increased demand for treatment somehow de-legitimises its suitability, I am aware of the potential concerns about licensing. However, just because a product is unlicensed, it does not necessarily mean that it is unsafe, as has been highlighted in MSD’s notice of cessation. In fact, in this case the unlicensed treatments being provided have been widely used across the country and the world. The only reason they are currently unlicensed is that the license holder deemed its provision economically unviable That brings me to my conclusion. My constituents found the Chelsea and Westminster clinic through independent research on the internet. That is not a good enough procedure to ensure that women have access to the vital services they need in our health care system. I, for one, recognise the positive changes that this Government have made to our health care system—namely the emphasis on the importance of well-being. I also believe that, for the most part, our doctors are best placed to commission our local services, but this case is an example of where the economics of devolved commissioning are perhaps having a negative impact on specialist services The Chelsea and Westminster clinic is proof that there is clearly a recognised medical need for the HRT implant to be made available, as a uniquely successful treatment, to a significant minority of women. I therefore ask the Minister to commit to take steps to ensure that our shared vision of our health care system is a reality for all who use it, including these women. I urge the Minister to take steps to make sure that this specialised service is available to all women who may need it, in an appropriate location, and that appropriate referrals take place. To follow any actions that he may take on this issue, will he make a commitment to publish new guidance or write to GPs to inform them about best practice for their patients in this position Looking forward, we also need to understand early menopause better and how it may be affecting women from an earlier age. I urge the Minister to engage with national organisations such as the Daisy Network, which was set up for this age group to see how best we can do that. We also need more research into severe menopausal symptoms and treatment for them. Will the Minister commit to look at this whole area of concern Finally, I thank Val, Sarah and the rest of my constituents who have campaigned tirelessly on this issue. Their support has enabled me to raise this issue in the House not just for them but for many, many women across the nation in similar circumstances.