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LONDON, ENGLAND – OCTOBER 25: Confirmed Chancellor of the Exchequer Jeremy Hunt leaves Number 10 in Downing Street as new Prime Minister Rishi Sunak begins cabinet reshuffle on October 25, 2022 in London, England. Rishi Sunak will take office as the UK’s 57th Prime Minister today after he was appointed as Conservative leader yesterday. He was the only candidate to garner 100-plus votes from Conservative MPs in the contest for the top job. He said his aim was to unite his party and the country. (Photo by Leon Neal/Getty Images)
NICE job

NICE job

LONDON, ENGLAND – OCTOBER 25: Confirmed Chancellor of the Exchequer Jeremy Hunt leaves Number 10 in Downing Street as new Prime Minister Rishi Sunak begins cabinet reshuffle on October 25, 2022 in London, England. Rishi Sunak will take office as the UK’s 57th Prime Minister today after he was appointed as Conservative leader yesterday. He was the only candidate to garner 100-plus votes from Conservative MPs in the contest for the top job. He said his aim was to unite his party and the country. (Photo by Leon Neal/Getty Images)

£300,000 for a precious tweak to healthcare policy

MPs and peers lobbied to block a change in health guidance that would have hurt the businesses that funded their all-party parliamentary group, Tortoise has found.

In 2018, members of an obscure APPG which receives funding from medical device companies wrote to the then-health secretary Jeremy Hunt and NICE, the healthcare watchdog, challenging draft guidelines that would have limited the use of a treatment known as EVAR.

EVAR stands for endovascular aneurysm repair, a minimally invasive procedure used in the treatment of abdominal aortic aneurysms (AAA). NICE’s draft guidelines had recommended a move away from EVAR in AAA in favour of open surgery. 

The letters to Hunt and NICE were part of a campaign to challenge the guidelines, coordinated by a consultancy firm, HealthComms, that also acted as secretariat for the vascular and venous APPG. 

Donations to this APPG from medical device companies have totalled more than £300,000 since 2016. Donors include Medtronic, Terumo, Gore Medical and Cook Medical, all of which make and promote devices used in EVAR and stood to lose from the guidelines’ recommendations.

According to the HealthComms website, the campaign brought together support for EVAR from clinicians, industry and charities as well as MPs and Lords who “engaged with ministers and officials from NICE”. 

The website  boasts about the campaign, stating that in 2019 HealthComms and the APPG won a prestigious lobbying award.

In fact the company was branded PB Consulting at the time – a firm founded by Paul Bristow, now MP for Peterborough, whose wife now acts as its managing director. 

At least two members of the Vascular and Venous APPG wrote to Jeremy Hunt and NICE arguing for continued NHS use of EVAR. One letter was on parliamentary headed paper despite the fact that APPGs’ work is not official parliamentary business.  

The MP Derek Thomas, who also raised the matter in the Commons, argued in his letter that the revised guidelines would deprive NHS patients of a treatment option. He told Tortoise he felt the guidance “would have had a negative impact on individuals who needed this procedure”.

Another letter signed by Baroness Masham said “the consequence of this draft guideline is that a British product, available across the world as a standard of care, will no longer be available to patients in Britain,” referring to EVAR-related devices produced by one of the APPG’s donors.

The chair of the NICE guideline committee, Professor Andrew Bradbury, complained he had received letters on “fancy-pants” paper, and said he only subsequently became aware that the MPs and Lords were “close to industry”.

HealthComms says its campaign formed part of a broader consultation on the draft NICE guidelines and that there was “overwhelming criticism of the proposed update to the guidelines.”

When the final guidelines were published in 2020, some academics described them as a U-turn. Professor Bradbury said they represented “business as usual” for EVAR.

NICE denies performing a U-turn and says the revised guidelines were “consistent with the need to move clinical practice away from EVAR… but in a way that is more manageable for the service to deliver.”

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