argyrotsipi/train-dataset huggingface dataset:
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I thank my hon. Friend. When it comes to the issues I want to come on to talk about, it is not so much my practice as a doctor, but the fact that several years before becoming an MP I worked for the national clinical audit commission. The whole task of that organisation and very many other organisations in the NHS is to attempt to get clinical practice to change. There can be evidence and acceptance of what is best, and it does not happen, for very many reasons. That is the point I am trying to get across today I understand the focus on this particular treatment and I do not in any way underestimate the impact on patients but, as a constituency MP, I have several other examples of other treatments and other things people want to have on the NHS that they are not able to access. We have to think about how we tackle that in the broader sense, and I do not believe that picking out a particular treatment and putting it into primary legislation is the way to do that.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): The point to draw from my hon. Friend’s intervention is that I have been working in this field for some time and I cannot think of any other example where we have decided to set aside all the ordinary processes that have been developed over many years, with great thought and attention to ensuring they are equitable in terms of resources, the NHS’s time and NHS researchers’ time, and come up with a whole separate process for determining the evidence on a particular treatment. That has never happened before that I am aware of I am happy to take an intervention from anyone on the Opposition side who can give me an example of when we have ever done that before, putting in place and encouraging the use of a particular treatment. I notice they do not—
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): All I would say is that those discussions need to be had with NICE, the NIHR and the Department of Health and Social Care and many other people, but to use primary legislation is not the appropriate way to do it, I am afraid.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I respect the experience that the hon. Member brings to her role. At no point have I said that the only way in which we can proceed is through RCTs. Earlier in the debate, when Opposition Members started talking in broad terms about observational studies and, to my mind, they were unfortunately disparaging RCTs, my comments were about being cautious. RCTs are incredibly important—they are fundamental to the vast majority of clinical medicine. I agree that other types of studies will be needed in some circumstances, but people need to make those arguments to the National Institute of Health Research. It is not for us as parliamentarians to override well-established processes designed to ensure that things are done in an appropriate, fair, thought-through and well-funded way.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Katherine Fletcher (Conservative, Centre-right): Briefly, I think I heard the hon. Member for Tooting (Dr Allin-Khan) talk about an RCT being immoral, implying that there is only one specific type of study design. She is talking about an RCT that would include forcing a placebo on children who are receiving medicine at the moment, but does my hon. Friend agree that RCTs can be designed in other ways and that we should not tar them all with one brush?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I will go on to talk about what I think you need to do—when I say "you", of course, I mean the clinical community rather than the hon. Member—to advance these issues. I am afraid that very difficult work needs to be done across many parts of the clinical community, involving engagement with individual clinicians. The last thing we should be doing is creating a new mechanism for the appraisal of a clinical treatment in the NHS. I cannot support that when there are already well-established, well-developed mechanisms for the purpose which do not rely on any particular randomised control trial, for example. We know that, because several treatments have been approved, although it has been argued that cannabis-based treatments cannot be approved in the existing frameworks.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): There is a difference between presenting a Bill that seeks to establish frameworks and approaches that have had a wider application and seeking to use a Bill to advance a particular medical treatment. There is not another example of that in the House. The examples that the hon. Member has given did not seek to advance a particular medical treatment through primary legislation. I do not consider that acceptable.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I entirely agree. For example, if this legislation were seeking to reform or amend the general approach that we take to the appraisal of healthcare technology treatments in the NHS, I might have more sympathy with it, but it is not seeking to do that. Its promoter has picked out a particular line of medical treatment and sought to use primary legislation to drive it forward, and for the reasons I gave earlier relating to the history of deciding what treatments doctors should or should not be using, that is something about which I am extremely uncomfortable, although I am very sympathetic to the individual cases that Members have been raising.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
James Barry Daly (Conservative, Centre-right): In November 2019, NICE conducted a review of the international evidence available in respect of this important issue. The report that followed was essentially inconclusive, but it did consult widely and obtained a wide range of information on some of the issues that Members have rightly identified. If the commissioning proposal in the Bill went ahead, how would the relationship with NICE and its statutory responsibilities work in this situation?
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): As my hon. Friend says, this is creating complexities and competing relationships that need to be given considerably more thought, rather than our aiming to promote a particular treatment We have talked about the risks. I now want to describe some of the many ways in which healthcare practitioners are held to account for their decisions. This is particularly important in relation to the unlicensed use of a medicine. First there is the sense of personal, moral or social responsibility that we would hope anyone involved in healthcare feels. Even if we do not necessarily take the Hippocratic oath any more, we are signed up on the basis of the fundamental principle, "First, do no harm". Understanding that can be complicated, as I have tried to explain in relation to side-effects, for example Secondly, we are accountable to our employer. For example, a person working in a hospital is not free to practise as they wish. Their employer will have reasonable expectations that they ensure that their practice is safe, evidence based and works in the best interests of their patients. Increasingly, employers will place a big emphasis on following best practice guidelines from royal colleges, the National Institute for Health and Care Excellence and others that restrict their practice in some regard.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I think the hon. Member will understand that legislative progress is not an exercise purely in discussion. We should not be putting forward legislation if Members on one side of the House do not feel that that legislation should be passing into law. I am very happy to say that, for the reasons that I have outlined and will continue to outline, I do not feel that this legislation is appropriate, and I do that and will still sleep soundly tonight. It does not mean that I do not understand the deep concern, the hurt, and the anguish that individual parents are feeling. As I have said, I have worked in this field for a long time. There are very many people who suffer hurt and anguish in relation to treatments. I can talk about my own personal experience. My mother was diagnosed and treated for cancer. There was a period of a couple of years where I had seen a treatment that I wanted her to be on because I felt that it would be effective. There was some evidence to suggest that it was effective. We had to wait a couple of years for the further studies to come out, recommending that particular treatment. I have a young boy in my constituency, or a neighbouring constituency, whose family has raised an enormous amount of money to go to another part of the world to try a treatment that we do not consider to be sufficiently evidence-based—
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): The Member shouts from a sedentary position, but I am afraid that we are talking about a relevant issue. Labour Members want unlicensed treatments to be brought forward. There is a mixture of unlicensed treatments and licensed treatments.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): Members say that they do not want to achieve that, so why are they bringing forward this legislation? If they do not think that it will make a difference to the use of a treatment, why are they bringing this Bill before the House? They must think that it will have an impact.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I completely agree. I would just add that processes are in place because we are at the greatest risk of making mistakes when we are faced with people in very desperate circumstances. The risk is greatest when a parent is extremely concerned for the welfare of their child, or when someone has a terminal illness. Those are the types of scenarios where people are most at risk of having the wrong treatment. I gave the example, which is incredibly important to remember in the wider discussion, of the MMR cases. Parents were advocating very, very strongly that that treatment had caused damage and distress to their children. Doctors were involved in amplifying and giving credibility to that circumstance. As a result, fewer people took their vaccines. I say this with all compassion to individual parents, but we have to retain a degree of objectivity, and I am afraid that parental passion is not a substitute for the systems we put in place.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Lia Nici-Townend (Conservative, Centre-right): We all know there are a huge amount of emotions around this argument. All of us, I think, across the House would like to see the situation move forward. The issue is that the proposed legislation will not move things forward. In fact, it has the potential to slow the whole process down. If I understand it correctly, a private Member’s Bill cannot bring forward any money resolutions. What we need here is money, and for CCG and NHS processes to be working properly. We do not need primary legislation to do exactly what hon. Members across the House want. We just need to get on with it via the NHS and CCGs.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I am not familiar with the discussions the hon. Member may or may not have had—I am sure the hon. Member did have them—with the Government in relation to pots of money. Again, I will gently say that there are enormous pressures on NHS budgets. That is why we have NICE, for example, to take out some of the emotion and personal feelings people have in relation to clinical care, and to try to look objectively at what secures value for money. I am not aware of what work the Department may have done on whether this represented an equitable use of resources for this particular area of clinical care. I will be happy to write to the Minister and make inquiries, as I am sure Opposition Members and the all-party group have done.
Medical Cannabis (Access) Bill — House of Commons, 2021-12-10
Topic: Health
Kieran John Mullan (Conservative, Centre-right): I agree. I am sure that that is part of the reason why some treatments secured a licence and NICE approval. Again, we must not give the impression to people listening to the debate that the NHS’s systems are not engaging with this issue. I am sure that some treatments were approved. I am sure—or would hope, if the evidence is there—that future treatments might also secure approval as we go forward, particularly if the evidence is there to demonstrate that they are of use. I just reiterate that the things that Members on the Opposition Benches have been asking for have been happening. It may be at a rate that frustrates them, but I share that frustration, as do many others, and it goes across lots of different clinical treatments. I have direct experience of it, and it is not just an issue for the NHS; it is a global issue for modern healthcare systems when a vast amount of money is going into medical research with new treatments all the time. Governments need systems to decide which treatments they approve and so that they can look at the evidence properly. That is why we have the MHRA, NICE, the royal college guidelines and NHS best practice guidelines. All those things are in place.
Children and Young People with Complex Needs — House of Commons, 2021-12-10
Topic: Health
Darren George Henry (Conservative, Centre-right): I hear my hon. Friend’s point about care in the community, which is essential and something we need to focus on. Children and young people with complex needs too often end up in hospital, which is not the right place for them, as they end up being affected by people in hospital with other issues. Care in the community is essential. How can we give local authorities the onus and the investment to make this happen?
Topical Questions — House of Commons, 2021-11-08
Topic: Health
Questions: North Devon still sees twice the number of jobseekers as pre-pandemic, yet employers across my constituency are desperate for staff of all skill levels. What steps is my right hon. Friend taking to match jobseekers with vacancies?; I refer to my entry in the Register of Members’ Financial Interests. DWP staff report that Serco telephony services are causing excessive call times because the private sector staff are poorly trained. How much is this outsourcing obsession costing the taxpayer, and is it fair on claimants who face hours hanging on the phone only to receive often questionable advice?; Will the Minister update me on the In-Work Progression Commission’s report and explain how this will help my constituents to earn more and progress in their careers?; Almost exactly a year ago, I had the privilege of serving on the Bill Committee for the Pension Schemes Act 2021, which was widely appreciated by the industry as being an outstanding piece of legislation. One of the best parts of that Bill was pensions dashboards, which enable people to better understand and impact on their pension savings. Can my hon. Friend in a short time give an update on the implementation of pensions dashboards and undertake to write to members of the Committee with a more detailed response?; In breaking the pensioners’ promise by unlocking the triple lock, many pensioners in my constituency, where there is an extremely high cost of living, will struggle this winter with heating and food. What steps will the Minister take to ensure that they receive the money they rightly deserve and that he promised the electorate to get through this winter?; Many sectors, as we have heard, are struggling to get the staff they need, such as social care, hospitality, janitorial services, haulage and logistics. Can my right hon. Friend tell the House what further steps she is taking to enable jobseekers to find jobs, and businesses to find the staff they depend on to remain prosperous in my constituency?; The new Help to Claim contract tender only specifies digital and telephone channels, yet a large number of claimants who need this service find those channels impossible to use and need face-to-face advice. Can the Minister confirm that there will be no removal of funds from face-to-face services and that potential claimants will still be able to access help via face-to-face advice?
David Henry Rutley (Conservative, Centre-right): We are committed to making sure that the best advice is available to people. We have clearly moved on from the depth of the pandemic, and we are looking at how best we respond. I will come back to the hon. Lady with more detail on how we propose to move things forward.
Topical Questions — House of Commons, 2021-11-08
Topic: Health
Questions: North Devon still sees twice the number of jobseekers as pre-pandemic, yet employers across my constituency are desperate for staff of all skill levels. What steps is my right hon. Friend taking to match jobseekers with vacancies?; I refer to my entry in the Register of Members’ Financial Interests. DWP staff report that Serco telephony services are causing excessive call times because the private sector staff are poorly trained. How much is this outsourcing obsession costing the taxpayer, and is it fair on claimants who face hours hanging on the phone only to receive often questionable advice?; Will the Minister update me on the In-Work Progression Commission’s report and explain how this will help my constituents to earn more and progress in their careers?; Almost exactly a year ago, I had the privilege of serving on the Bill Committee for the Pension Schemes Act 2021, which was widely appreciated by the industry as being an outstanding piece of legislation. One of the best parts of that Bill was pensions dashboards, which enable people to better understand and impact on their pension savings. Can my hon. Friend in a short time give an update on the implementation of pensions dashboards and undertake to write to members of the Committee with a more detailed response?; In breaking the pensioners’ promise by unlocking the triple lock, many pensioners in my constituency, where there is an extremely high cost of living, will struggle this winter with heating and food. What steps will the Minister take to ensure that they receive the money they rightly deserve and that he promised the electorate to get through this winter?; Many sectors, as we have heard, are struggling to get the staff they need, such as social care, hospitality, janitorial services, haulage and logistics. Can my right hon. Friend tell the House what further steps she is taking to enable jobseekers to find jobs, and businesses to find the staff they depend on to remain prosperous in my constituency?; The new Help to Claim contract tender only specifies digital and telephone channels, yet a large number of claimants who need this service find those channels impossible to use and need face-to-face advice. Can the Minister confirm that there will be no removal of funds from face-to-face services and that potential claimants will still be able to access help via face-to-face advice?; Since leaving the EU, it is right that all those in the UK who are entitled to benefits receive them, so what steps is my right hon. Friend taking to ensure that our post-Brexit benefit rules are applied fairly and consistently for UK and EU citizens alike?
Peter James Guy Aldous (Conservative, Centre-right): Motor neurone disease is a cruel and relentless condition. Too many people with MND and other terminal illnesses are struggling to access the benefits that they need. The Northern Ireland Executive have committed to introducing legislation this month to reform the unfair six-month rule. Will the Government follow their lead?
David Fuller Case — House of Commons, 2021-11-08
Topic: Health
Sajid Javid (Conservative, Centre-right): I very much welcome the right hon. Gentleman’s words and his offer to work together on this. I most certainly would like to take him up on that. I think the whole House would want to see us all working together on this I reassure the right hon. Gentleman that there is comprehensive support rightly available to all families and friends that have been affected. As I said a moment ago, every family of the known victims has been contacted directly by family liaison officers. They are in touch, and that support will continue for as long as necessary, including dedicated caseworker support, a 24/7 telephone support line and whatever counselling and support of that nature is needed. That includes support for staff in the NHS and elsewhere, where staff will also be affected On the terms of reference, that is something that I and my Department will work on with Sir Jonathan. I have already started discussions with him on that, and I am sure that he will want to have discussions with others, including families, their representatives and the Members of Parliament who represent those families The work that Sir Jonathan will do will be broad in its nature. I think it has to be, because, as the right hon. Gentleman rightly alluded to, it has to go beyond just hospitals. There are a number of settings that rightly need to be looked at, including, for example, local authority mortuaries, private mortuaries and other settings, such as undertakers. I think the inquiry should be open to all of that, and I think we would want to see that reflected in the terms of reference Lastly, the right hon. Gentleman referred to recommendations around access, documentation and CCTV. He is right to raise all those issues. I want to be careful not to pre-empt the final outcome of what is an independent inquiry, but I am sure all those issues will rightly be looked at.
David Fuller Case — House of Commons, 2021-11-08
Topic: Health
Sajid Javid (Conservative, Centre-right): I very much agree with all the words of my right hon. Friend, especially when he talks about the shock, hurt and pain of all the families, many of them his constituents. He asks specific questions on three points: whether the victims will be allowed to give evidence to the inquiry; whether the recommendations will be for the whole of the NHS and be public; and whether the inquiry will publish its findings on other sectors beyond the NHS. Absolutely, the inquiry will do all three things. I can give him that assurance.
David Fuller Case — House of Commons, 2021-11-08
Topic: Health
Sajid Javid (Conservative, Centre-right): Yes, I am very happy to expand on that. The NHS has, first, written directly to all trusts and asked them to look into the issues of mortuary access and other post-mortem activities, and to judge them against current guidance to ensure that it is all being applied. In the first instance, that information will go back to NHS England. It will then be shared with me and I will certainly want to find the best way of sharing it with both the House and everyone who is interested.