Lib Dem MPs on health crisis: government has got it badly wrong

One of the most stunning non-answers in the House of Commons of late was Liz Truss’s response to Daisy Cooper at PMQs yesterday on the danger of collapsing hospital buildings. The here today, and possibly gone tomorrow, prime minister either didn’t hear the question or did not know how to respond (Hansard).

In a debate in Westminster Hall, Daisy Cooper was again in action, this time on the preventive covid-19 drug Evusheld. This is a pre-exposure prophylactic drug administered by injections that gives a degree of protection against catching Covid-19. There are around half a million immunosuppressed people in the UK who could benefit from this treatment, including people who cannot be vaccinated for medical reasons. But the government refuses to make it immediately available, instead waiting on a NICE review which may not conclude until well in 2023, after the expected winter surge in illness, including Covid and seasonal flu. Cooper said the government had got this “badly wrong”.

Daisy Cooper told MPs:

Let me be blunt: the Government have got this badly wrong. Some of our most vulnerable people are now in an impossible position, or, as some of them have said, they have been left to rot. People with blood cancer, vasculitis, kidney transplants, multiple sclerosis, long- term conditions and rare diseases and those on immunosuppressant drugs are crying out for the preventive drug Evusheld. Why? For them, the covid infection is just as deadly—in fact, more so—than when we first went into lockdown two and a half years ago. They do not mount a response to covid through the vaccines like the rest of us. Covid is not just a bad cold or an inconvenience, but a killer disease. In a society where people are allowed to walk around with that killer disease without being required to wear a mask, test or isolate, nowhere is safe for the immunocompromised—not inside or out.

Daisy Cooper’s words came after the British Medical journal reported immunocompromised patients are frustrated at the government’s inaction on rolling out the preventive drug. Not all variants are neutralised by Evusheld but no protective treatment is ever 100% effective.

Daisy Cooper:

There is nowhere that is safe for these people: not shops, not schools, not supermarkets, not buses, not even the very GP surgeries and hospitals that they need to visit to manage the conditions that make them vulnerable. They are at extreme risk of hospitalisation and death, and they have been left with no choice but to lock themselves away from family and friends for two and a half years. Many now face a third winter of shielding…

Evusheld is now so effective that not only has it been rolled out in 33 countries, but a number of countries, including Japan, Italy, Spain and Israel, have actually put in repeat orders for Evusheld, and the Centers for Disease Control and Prevention in the US has even launched a public drive to increase uptake.

Many people are clinically vulnerable because they have a health condition, and their physical health is getting worse, as it would when someone is stuck at home for two and a half years, but the mental health impact is also incredibly profound. We know that many of our constituents have experienced suicidal thoughts…

Two years ago, Members stood in this room and begged Health Ministers to change their minds on care home restrictions, which were supposed to protect people but were so tight that some people started dying of neglect. We are at risk of that happening again.

Earlier in the week, Helen Morgan wrote about the ambulance crisis in the West Midlands after 12 hours with a Shrewsbury crew. It has received extensive local media coverage and it is worth reading if you have not already done so.

Liz Truss may be oblivious to the mounting health crisis. But those that cannot get the treatment they desperately need are not. As Daisy Cooper said, the government has got it badly wrong.

* Andy Boddington is a Lib Dem councillor in Shropshire. He blogs at andybodders.co.uk.

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7 Comments

  • David Garlick 14th Oct '22 - 10:13am

    I agree and support the work done by our MPs on Health. I know that to correct/improve the situation will require improvements in the way we use the money already in the system but above all I know that the NHS needs more, much more money if it is to survive and thrive. It is terminally ill, and the Government refuses access to resus and has no plan for its long term care. Sounds like everything else the Government has responsibility for. It cares for us from the cardle to the grave but is on its last legs. Can we make it clear that the Lib Dems would save it and, Yes It Will Cost More Taxpayes Money!’ to do so.

  • …the preventive covid-19 drug Evusheld.

    This might best have been advocated earlier in the year. I suggested “if safe, fast track the approval and deployment of AstraZeneca’s EvuSheld” back in December 2021…

    ‘8 December 2021 – today’s press releases’:
    https://www.libdemvoice.org/8-december-2021-todays-press-releases-69320.html#comment-564326

    It’s no longer efficacious against some emerging variants…

    ‘Further humoral immunity evasion of emerging SARS-CoV-2 BA.4 and BA.5 subvariants’ [27th. September]:

    Cilgavimab did not affect BA.4 and BA.5 sublineages with Arg346Ile, Arg346Thr, or Arg346Ser mutations, resulting in the complete loss of efficacy of Evusheld (tixagevimab with cilgavimab) against BA.4.6, BA.4.7, BA.5.2.6, and BA.5.9 sublineages.

  • The Numbers Needed to Treat for Evusheld is 134 (i.e give 134 immunocomprimised people the two doses and you will prevent 1 Covid-19 infection from that cohort). The cost of a course of treatment is £1,600, and gives protection for 6 months. The most cautious mortality rate from Covid-19 for immunocomprimised people is 10% (likely lower). So in order to prevent 1 death from Covid-19 for 6 months, it will cost more than £2 million. This is before factoring in Covid-19 variant evolution lowering efficiacy, and the side effect profile of Evusheld with its known thrombotic and cardiac events.

    I can tell you now, this will not pass NICE’s cost effectiveness threshold except possibly for young children with congential immunodeficiency.

    There is a reason we have non-political agencies like NICE to guide the best use of limited NHS resources. Politicans using emotion and populism to score political points and force the hand of the government to overrule the experts, is very very cheap.

    @David Garlick

    One reason the NHS is struggling with resourcing, is because patient lobby groups (backed by the pharmaceutical sector) continuously try and pressurise the government to interfere in NHS resource allocation towards extremely expensive therapies with limited benefit. So cutting edge technologies are deployed for fashionable ailments (such as Covid, but most commonly cancer), thus removing resources from providing the highly cost effective bread and butter services that the NHS has excelled in delivering for decades. This needs to stop

  • The NHS continually needs additional resources as demographic changes increase demands on the services year by year. Currently, there is even a deeper crisis in the provision of Adult social care with so many staff leaving the sector and 165,000 unfilled vacancies. Local councils need very significant increases in funding to be able to meet the needs of the elderly and physically or mentally handicapped individuals.
    With the abandonment of the health and social care levy alternative sources of funding other than increased borrowing need to be pursued.

  • David Garlick 14th Oct '22 - 4:53pm

    @James Pugh
    I cannot disagree that the scarce resources are subject to lobbying pressures and robbing Peter to pay Paul.
    My beleif is that the ailments you describe as expensive and fashionable (not sure that either would go down well with anyone suffering from them) don’t need to have to chase for scarce resources. The plain fact is that there needs to be more money in the NHS and I would advocate a penny for the NHS on the basic rate and 2p on any higher rates.I want to restore the NHS as the envy of the world or at least something to be proud of. At the moment we are heading to become not only the poor health care man of Europe but emerging economies will be overtaking us. Good for them.

  • >The plain fact is that there needs to be more money in the NHS and I would advocate a penny for the NHS on the basic rate and 2p on any higher rates.

    It will be interesting to see if the Lords vote for Kwasi’s “Health and Social Care Levy (Repeal) Bill” on October 17th. this bill repeals both the NI changes Rishi made and the creation of the 1.25% Health and Social Care Levy due to commence April 2023.

    Given Kwasi has gone, it would make logical sense to revert the entirety of his “not a budget” financial statement…

  • James Pugh 14th Oct ’22 – 11:13am:

    Good informative comment.

    I can tell you now, this will not pass NICE’s cost effectiveness threshold except possibly for young children with congenital immunodeficiency.

    Indeed; the loss of efficacy against current Omicron variants likely makes it no longer viable even if the NHS could negotiate a lower price. Those countries already using it did so on the basis of its proven efficacy against the more pathogenic Delta variant.

    Politicians using emotion and populism to score political points and force the hand of the government to overrule the experts, is very very cheap.

    Absolutely. And also accepting advice from experts who are politically or ideologically motivated.

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