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Strep A Treatments: Supply
19 December 2022
Lead MP
Maria Caulfield
Debate Type
Ministerial Statement
Tags
Business & TradeBenefits & Welfare
Other Contributors: 19
At a Glance
Maria Caulfield raised concerns about strep a treatments: supply in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Minister Maria Caulfield reassures the House about the recent outbreak of streptococcus group A infections among children, acknowledging that while most cases are mild and treatable with antibiotics, some have developed serious infections. She states that the UK Health Security Agency has declared a national enhanced incident to co-ordinate public responses. There were supply issues due to increased demand, but stock of antibiotics is available. The government has taken several steps including convening roundtables with manufacturers and wholesalers to boost supplies, issuing eight serious shortage protocols for alternative antibiotics, and adding certain medicines to the list that cannot be exported or hoarded. Further guidance was provided to GPs and pharmacists on managing supply issues. She assures families that they are handling the higher-than-normal number of strep A cases this winter.
Daisy Cooper
Lib Dem
St Albans
Question
The hon. Lady questions why the government took so long to act on antibiotic shortages, despite health professionals raising concerns for weeks and prescriptions showing an increase a month ago. She highlights issues faced by parents, GPs rewriting prescriptions, and A&E departments being overwhelmed due to delays in addressing supply issues.
Minister reply
The minister reassures that serious shortage protocols have been issued routinely when there are supply pressures. There is stock of antibiotics but supply issues arise from significantly increased use due to UKHSA guidance lowering the threshold for prescribing antibiotics. New SSPs allow alternative antibiotics if Penicillin V is unavailable, and pharmacists have flexibility in dispensing medication.
Question
The hon. Member asks about tetracyclines being less effective with certain ethnic groups and suggests encouraging parents to get their children flu vaccinations as serious strep A infections often follow viral infections.
Minister reply
The minister agrees on the importance of flu vaccination for winter seasons and highlights that the highest number of streptococcus group A deaths are in over-65s. She emphasises that alternative antibiotics recommended by UKHSA have been approved, and clinical advice has been followed.
Wes Streeting
Lab
Ilford North
Question
May I wish you, Mr Speaker, and all staff of the House a merry Christmas?... The Government must get a grip on this situation and be honest with the public about the reality on the ground.
Minister reply
Let me reassure Members that, as I said in my opening remarks, there is no shortage of antibiotics to deal with strep A. There have been pressures on supplies; there have been five to six times the amount of prescriptions that are normally issued at this time of year... We did lower the threshold to prescribe antibiotics and they have gone above and beyond in seeing as many children as they can, as quickly as possible.
Question
Group A streptococcus has been associated as a trigger for PANDAS—a distressing autoimmune neuropsychiatric disorder in children... to discuss how we can develop and move towards a treatment pathway for PANDAS in the UK?
Minister reply
I thank my hon. Friend for raising this important point. UKHSA is looking at the data on this outbreak and previous ones. I am happy to meet him to discuss that, particularly if he has details of treatment options he feels are not being pursued at the moment.
Question
Does the Minister accept that no production lines in UK pharmaceutical suppliers are operating... Will she ensure that this is put right before Christmas so that our local, British pharmaceutical manufacturers can produce the right antibiotics to give to all our children who need them so desperately?
Minister reply
Perhaps if the hon. Gentleman had not been heckling me throughout my opening remarks, he would have heard that we are working with manufacturers and wholesalers across the country. Manufacturers are opening up new production lines and those supplies will be hitting pharmacy shelves very soon.
Question
I recently visited Broomfield Hospital and was concerned to hear that the paediatric A&E was seeing three times as many children as was normal for this time of year... will my hon. Friend join me in urging all parents, especially those of two and three-year-olds, to go out and get that protection against both flu and strep A by getting their child the flu vaccine?
Minister reply
My right hon. Friend is right to encourage parents to take their children for the flu vaccine. She is also right to highlight the level of demand in her local A&E. Parents are doing the right thing. If they are concerned about their children, they should get them seen as early as possible.
Ellie Reeves
Lab
Lewisham West and East Dulwich
Question
It is currently suggested that parents contact 111 or book a GP appointment if they are concerned about strep A... What are the Government doing to ensure that diagnosis and treatment are expedited, because no more families should be facing the prospect of mourning this Christmas?
Minister reply
The hon. Lady is right to raise that matter. Every day, we monitor the number of appointments with GPs, A&E visits, pharmacy visits and the impact that those are having on our stock levels of antibiotics, and the number of incidents of positive cases... Scarlet fever is a notifiable disease, so we are able to track this fairly easily.
Question
It is good to hear that there is no shortage of antibiotics, and I know that many parents in my constituency will be reassured by that... What steps are the Government taking to make sure that antibiotics are delivered to a range of places, particularly those areas where there is a larger outbreak, because that is where they will be needed the most?
Minister reply
My hon. Friend makes a valid point. While we do not have a shortage, there are, as I have clearly outlined, supply issues... If they go in with a prescription for penicillin B and are given amoxicillin, clarithromycin, flucloxacillin, cephalexin, co-amoxiclav or erythromycin, for example, that is because they are recommended as alternative antibiotics that can adequately treat strep A.
Jim Shannon
DUP
Strangford
Question
I am sorry, Mr Speaker, but you caught me unawares there... Can this be made available? The Army medics are perhaps the solution.
Minister reply
I am sorry to hear about the problems that the hon. Gentleman’s constituent has had in accessing help. We do recognise that there are serious pressures... Winter is a busy time for GPs in the best of years, but this year, with strep A, UKHSA and officials are encouraging parents to come forward, and parents are doing exactly the right thing.
Stella Creasy
Lab Co-op
Walthamstow
Question
A parent in the MP's constituency is struggling to find antibiotics for her son diagnosed with strep A. She has managed to get only a third of the prescription, and she still does not have the drugs needed.
Minister reply
The Minister acknowledges supply issues and advises that pharmacists have flexibility since before last week to adjust doses and preparations, and since Friday they can issue alternative antibiotics.
Cat Smith
Lab
Lancaster and Wyre
Question
Concerns about strep A cases rising in the constituency and parents struggling to get GP appointments because of a logjam in the primary care system.
Minister reply
The Minister suggests that directors of public health may start children in classes or schools with known cases on prophylactic antibiotics, preventing strep A in the first place.
Chi Onwurah
Lab
Newcastle upon Tyne Central and West
Question
The MP visited a local pharmacy and saw empty shelves where antibiotics should be. Pharmacies are being asked to pay up to £19 for a box of antibiotics that would normally cost £2, with no commitment from the Government to reimburse this amount.
Minister reply
The Minister clarifies that no supplier should exploit the NHS and indicates that the Competition and Markets Authority is looking at price increases. The Government is working with PSNC to review concessionary price arrangements.
Clive Efford
Lab
Eltham and Chislehurst
Question
Parents report not being able to find antibiotics at pharmacies, and pharmacies are running out of supplies as soon as they come in due to high demand. The serious shortage protocols were only introduced last Thursday.
Minister reply
The Minister reiterates that the five SSPs issued on Friday were additional to the three previously issued. She advises MPs with problems in their constituencies to contact her directly for support.
Question
A young mum visited nine different pharmacies but could not find appropriate medication due to a shortage of antibiotics.
Minister reply
The Minister reassures parents that pharmacies can now dispense alternative antibiotics, which she lists as amoxicillin, clarithromycin, flucloxacillin, cefalexin, co-amoxiclav and erythromycin.
Hilary Benn
Lab
Leeds South
Question
There is confusion about whether there are sufficient stocks in the country to meet the increased demand.
Minister reply
The Minister confirms that there are sufficient stocks in the country to meet current demand.
Rachael Maskell
Lab Co-op
York Central
Question
GPs face challenges in accessing appropriate pharmaceuticals due to supply issues.
Minister reply
The Minister states that wholesalers have expedited deliveries and increased the number of deliveries, working with NHS England, UKHSA, and pharmaceutical bodies to ensure supplies are getting to pharmacies.
Barnsley South
Question
Parents in Barnsley are worried about access to medicine due to the shortage.
Minister reply
The Minister explains that they have been working with manufacturers and wholesalers to increase production, issue SSPs for flexibility, and plan further manufacturing improvements.
Grahame Morris
Lab
Easington
Question
Suggesting Bristol Laboratories in Peterlee as a potential domestic supplier of generic medicines.
Minister reply
The Minister agrees to look into the suggestion if more details are provided. She notes that the issue is not unique to the UK, with several European countries also reporting shortages.
Shadow Comment
Daisy Cooper
Shadow Comment
The shadow minister Daisy Cooper criticises the government's delayed response to antibiotic shortages, noting that at least 19 children have died from strep A since September. She asks why it took so long for serious shortage protocols to be issued when data on rising prescriptions was available a month ago. She raises concerns about the impact on parents and healthcare professionals due to delays in addressing supply issues. She also questions the government's ability to forward plan, citing previous shortages of lateral flow tests and hormone replacement therapy. Finally, she asks for updates on the Competition and Markets Authority investigation into antibiotic price rises and seeks assurance that families can access necessary antibiotics during Christmas.
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