Chris Seeks MHRA Transparency Regarding Vaccines
Esther McVey Conservative, Tatton 4:30, 16 January 2025
I beg to move,
That this House
notes that the Medicines and Healthcare products Regulatory Agency (MHRA) continues to need substantial reform, as recognised by the Independent Medicines and Medical Devices Safety Review (IMMDS), with patient safety concerns persisting and exacerbating since the review’s publication in 2020; believes that the MHRA’s 2017 expert working group report on Primodos was deeply flawed, with IMMDS later concluding the drug had caused avoidable harm;
further notes that the yellow card system for reporting suspected adverse drug reactions is failing, with no process for following up on serious or fatal reactions and conflicts of interest, with 75% of the MHRA’s funding being derived from industry fees, a concern raised in the Fourth Report of Session 2004-05 of the Health Committee, The Influence of the Pharmaceutical Industry, HC 42-I, published on 5 April 2005;
also notes the MHRA’s delayed response to reports of myocarditis, pericarditis and vaccine-induced thrombotic thrombocytopaenia following covid-19 vaccination, despite action from regulators in other countries;
and calls on the Government to fully implement the recommendations in the IMMDS review and to acknowledge the harm done to patients and the financial burden on the healthcare system as a result of the MHRA’s widespread regulatory failures.
I thank the Backbench Business Committee for granting this debate and the many colleagues from across the House who supported my application for it, especially Graham Stringer, and also the hon. Members for Bolton South and Walkden (Yasmin Qureshi) and for Great Yarmouth (Rupert Lowe).
The Medicines and Healthcare products Regulatory Agency is the body responsible for ensuring the safety and efficacy of medicines used in the UK. Its job is to oversee medical products, medicines, medical devices and blood components for transfusion. The responsibility it has is extremely important, as it comes with the potential not only to change people’s lives for the better, but to cause serious harm—even death—if poor decisions are made or safety signals are missed.
The MHRA is required to scrutinise applications from the pharmaceutical companies for new products and devices and to remain ever vigilant over existing drugs should safety problems arise post-authorisation. It has to weigh up the arguments for and against these products and devices. After all, the companies trying to get these products on to the market—and to keep them there—are driven, as all industries are, by commercial success. It is up to the MHRA to balance that with the health and safety of the UK and the public.
Alarm bells rang for many of us when, in March 2022, Dame June Raine, the chief executive of the MHRA, boasted of the agency’s transition from watchdog to enabler. Twenty years ago, the Health Committee report, “The Influence of the Pharmaceutical Industry”, found that the MHRA was unusual in being one of the few European agencies
“funded entirely by fees derived from services to industry”.
Not much has changed since, with the MHRA continuing to get 75% of its funding from the pharmaceutical industry. In this context, the agency’s transition from watchdog to enabler does little to quell suspicions of conflicts and the implications that has for patient safety.
One of the most worrying issues is the MHRA’s mismanagement of the yellow card system. Established in 1964, the system is a way for patients, relatives and healthcare professionals to report suspected adverse reactions to drugs or medical devices. The reporting scheme should be a valuable source of information about possible harms, and act as an early warning system, but there is gross under-reporting to it. As the IMMDS’s 2020 review put it, the system is
“too complex and too diffuse to allow early signal detection.”
Under-reporting is a big problem because it makes it difficult to spot safety signals and assign causation. That then translates into unnecessary harm or death, with devastating side effects from treatment going unnoticed for years, months or even decades. That was recognised by the IMMDS review led by Baroness Cumberlege in the case of Primodos, sodium valproate and surgical mess—I meant to say mesh, though perhaps the word should have been “mess.”
According to research from Bangor University in 2019, potentially avoidable adverse drug reactions cost the NHS £2.2 billion a year in hospital admissions. In 2018, the MHRA estimated that only 10% of serious reactions and between 2% and 4% of non-serious reactions are reported. More recently, it has claimed that reporting rates for covid vaccines are better due to higher public awareness, but it has not been able to point to published evidence to back up that claim. The yellow card is currently a voluntary scheme that doctors and members of the public can report to, but I echo calls from the Sling the Mesh campaign and others for the UK to follow the example of Denmark and Sweden by making it mandatory for all healthcare professionals to report suspected adverse reactions.
Let me turn to the MHRA’s failure to act promptly on evidence of adverse reactions. We have seen that historically. For example, sodium valproate was known to cause harm to unborn babies in the 1980s, yet the MHRA did not establish a valproate pregnancy prevention plan until 2018. The known harms to unborn babies were allowed to persist for over 30 years. More recently, in 2021, the MHRA reacted slowly to strong signals that there was a serious problem with the AstraZeneca vaccine causing an autoimmune condition called vaccine-induced thrombotic thrombocytopenia. Denmark and other European countries suspended the vaccine for all age groups on 11 March 2021. The MHRA, by contrast, only started to restrict the vaccine in some age groups nearly two months later, on 7 May—yet there was a signal in the yellow card reports as early as 8 February. How many people were needlessly exposed to a risk?
Christopher Chope Conservative, Christchurch
My right hon. Friend hits on an important point. What action did the MHRA take to apologise for or explain its failure to give adequate and timely warnings to potential patients?
Esther McVey Conservative, Tatton
I do not believe that the MHRA has taken such action. We are probably still waiting for it. Hopefully, that will come out. People are also either not getting compensation quickly enough or not receiving compensation that is commensurate with the illness and damage caused to them.
It is worth noting what happened when The Daily Telegraph reported on the potential causal link between the AstraZeneca vaccine and blood clots in March 2021. The journalist who wrote the story received a threatening call from the MHRA warning that The Telegraph would be banned from future briefings and press notices if it did not soften the news—an extremely defensive approach for an agency whose No. 1 strategic objective is to maintain public trust through transparency and proactive communication. Does that sound like an agency that is doing its best to maintain public trust, let alone patient safety?
It is clear that the system does not work. We have good evidence that suspected adverse reactions are under-reported, but what about the ones that are reported? We know from freedom of information requests that the MHRA does not have a process for investigating and following up individual yellow card reports. We know that the retrieval of follow-up information from the yellow card database still requires manual extraction and that only 54% of deaths reported as possibly linked to exposure to one of the covid-19 vaccines were followed up by the MHRA. That is extremely worrying or, as Matt Hancock infamously described it in a 2021 WhatsApp message, “shonky”. The chief medical officer, Chris Whitty, replied to that message by saying that the system “needs to get better”.
Another long-standing problem with the MHRA is its lack of transparency. Take FOIs to the agency as an example. Between 2008 and 2017, only 41% of requests were successful. In 2021, 76% were answered outside the 20-working-day statutory response time. A culture of delay and secrecy has emerged, and MHRA’s behaviour around the Commission on Human Medicines meetings for the covid-19 vaccine benefit risk expert working group show that beyond any doubt. Minutes of the meetings were published just last month, four years after they took place—why the delay? They are stuffed full of redactions that leave us with many more questions than answers, particularly as to why the new vaccines were continually described as safe and effective.
In the meeting on 18 November 2020, the expert working group asks if Pfizer was “required to respond to the 36 questions asked by MHRA”. In response, the MHRA confirmed that “there is no formal obligation to reply”. Why is there no formal obligation to reply? Surely it is essential, when making such an important decision as to whether to allow a new vaccine to be rolled out to the nation, to have those replies. The minutes do not specify the 36 questions. Indeed, they do not appear to have been mentioned again.
I asked a written question last week to see whether, in the spirit of openness and transparency, the MHRA would publish those questions and any answers received from Pfizer. The response was that the MHRA does not intend to publish those questions or any subsequent responses. Why not? Is this not a matter of public interest? Those issues were not resolved before the MHRA gave the green light to start the vaccination of the nation.
Particularly worrying is the issue of lymphopenia, where blood does not have enough white blood cells, which was reported in phase 1 of the trials and then went away—not because they fixed the problem, but because testing for the condition was not conducted in phases 2 or 3.
In summary, the failure to act on the weaknesses of the MHRA will lead only to more harm and further damage to the public’s trust in the pharmaceuticals agency and those tasked with regulating it. My hope is that the debate will help bring those wide-ranging issues further to light and focus the Minister’s mind on finding solutions. I will end on the words of Dr Tom Jefferson of the University of Oxford:
“You cannot support both secrecy and vaccination. Requesting data is not a sign of being against drugs or vaccines;
it shows that you favour transparency. Those who try to keep data confidential and criticise those who ask for evidence are anti an evidence-based approach. How can you have informed consent if you do not know precisely what is happening?”
Christopher Chope Conservative, Christchurch
On that point, does my right hon. Friend accept that one of the consequences of the lack of transparency has been a public distrust of vaccines, which is spreading rapidly? As a consequence, for example, there is less take-up of MMR vaccines than there should be and used to be, and that is because of a lack of trust in the system.
Esther McVey Conservative, Tatton
My hon. Friend makes a good point. If people lose trust in vaccines, the pharmaceutical industry and the regulatory agency, that is precisely what happens. We know that these vaccines are essential to many people, so we do not want that happen. We want to ensure that new vaccines and medicines coming into use are thoroughly tested and that, along the way, we keep an overall watch on whether they are working correctly.
Graham Stringer Labour, Blackley and Middleton South 4:44, 16 January 2025
It is a pleasure to follow Esther McVey. I agree with every word she said. It is late in the day for a Thursday, so I will try not to repeat many of the pieces of evidence and arguments that she proposed, but they are all valuable contributions to this debate.
I will start by talking about the attitude of Members of Parliament and politicians to regulation in general. A long time ago, I had responsibility in the Cabinet Office for dealing with better regulations. I travelled around the country to look at businesses that complained about regulations and see how those regulations could be made better—that was 18 months of my life that I will never get back. I came to a number of conclusions after that. Politicians have a knee-jerk reaction when it comes to regulation. If a child dies, if there is a fire, or if there is another disaster of some sort, there is a cry from both sides of the House for more regulation— not necessarily better regulation and enforcement, but more regulation—when, in many cases, regulations are already there but inspections and enforcement have not taken place.
The other knee-jerk response, which my Government are giving at the moment, is to say, “Regulations are burdensome so we will try to get rid of some of them.” I do not think that either of those responses deals with the issue. We set up regulators—this afternoon we are talking about the MHRA—but, by and large, once they are set up, MPs and Ministers abdicate responsibility and do not consider them until there is a crisis.
When I had that responsibility, I went to see the European Medicines Agency—this was some time before we left the EU. One of the surprising things I found—or maybe it was not so surprising—was that I was the only Minister who had been anywhere near the place. It was the major European agency that this country got after the Maastricht treaty. It had wide-ranging and important powers, to deal both with the market and with regulation, but nobody bothered with it. If there had been a crisis, however, Ministers and shadow Ministers would have been queuing up to go there.
If there is a lesson, particularly in relation to the MHRA, it is that we should look at regulators—be they water, medicine or other regulators—all the time. We cannot as a Government and MPs abdicate our responsibility, because we then come to a crisis, and the electorate say, “Well, what are you doing?” and the answer is, “Not a lot; we have passed that on.” Those water regulators or medical regulators might be, as the right hon. Lady showed, pretty useless. We should be looking at them all the time.
I was a member of the Science and Technology Committee in 2012. Partly because of that experience, and partly because there was a lot of press discussion and debate about metal hips that were squeaking and not working very well when they had been implanted and about breast implants that were falling apart, potentially damaging and poisoning the recipients, we had an inquiry that reported in October of that year. I will read out some of the comments from the witnesses we heard from about the MHRA, because they are being repeated now. They are very similar to what the right hon. Member for Tatton said about the MHRA’s responses—secretive and slow. For instance, there was evidence that there were problems with metal hips for four years before the MHRA took any action whatsoever. Nearly 14 years later, it still has the same problems.
I asked Dr Heneghan from the Centre for Evidence-Based Medicine at the University of Oxford who had authorised those metal hips. His answer was extraordinary: “Nobody knows. I don’t know—nobody knows.” It was a different regulatory regime then, because we were part of the European Union. Anybody who had the competence—or at least the authority—in any country in the EU could give authorisation, but nobody knew which body had done it, and whether that body was composed of competent people and what evidence they had used to do so.
However, when the MHRA found out, it did nothing for four years. That is disgraceful, and there were all sorts of comments that I can give the House. One was from Dr Stephen O’Connor at the Institute of Physics and Engineering, who said that the MHRA was overly bureaucratic relative to other competent bodies, inefficient, and difficult to deal with. As the right hon. Member for Tatton showed, the MHRA does not answer FOI requests, and it does not tell us what is going on.
The Lancet said about the breast implants, which I will talk about next, that the MHRA was in paralysis and in need of reform. Again, that was a long time ago. It was a different issue with the breast implants, because the MHRA was dealing with a fraudulent product—the products that had been authorised were not the products that were being sold to surgeons to be implanted in women. However, the Committee asked for there to be random and regular testing of the bodies that were responsible for manufacturing those implants. I do not expect the Minister to know at this time, but will she check whether the authorities have done any of those randomised tests on those bodies?
That is the history. The right hon. Member for Tatton has basically analysed what is going on now, but I will just talk about what we learned during the covid period. We learned that many of the NHS’s constituent parts—although not the clinicians—were secretive. Earlier today in the Chamber, we talked about the Government’s response to the first part of the covid inquiry. At the present time, that inquiry is not getting to part of what went wrong during covid, which was the fact that the NHS did not tell us what was going on, and there was also a restriction on political debate. If we are to get the best policies in any crisis, and in the regular turn of events outside crises, we need transparency so that we know how things can be improved and what we can criticise.
The right hon. Lady made the excellent point that keeping things secret encourages people who do not trust vaccines and have odd theories about how societies is controlled not to take the protection from vaccines. We know that no medicine is 100% safe, and there is no point in pretending they are safe, but vaccines have saved many lives over decades—more than decades; over a century—and it is good for society and for individuals that people understand that, and they will be less trusting if we do not tell them what is going on.
As recently as a few minutes ago, I got an email telling me that the UK Health Security Agency is still refusing to release the cost of the bird flu vaccines it has purchased. What possible reason can there be for not saying how much public money has been spent on a good cause? Having vaccines ready for any flu epidemic is a good thing because it saves people’s lives, as we have been discussing. Why should it be kept secret? Could the Minister to respond to that?
Is there any Member in the House who thinks that turning the MHRA, in the right hon. Lady’s phrase, from a watchdog to an enabler is a good idea, or even knows what it means and what is being enabled? I certainly do not know what is being enabled, but one of the things we should remember is that the MHRA and the whole of the health industry are swimming in a sea of pharmaceutical sharks. Pharmaceutical companies produce some extraordinarily wonderful products that keep us safe, but they also produce huge profits, and sometimes they get their products on to the markets by telling lies, or certainly by sins of omission. Everybody knows about the thalidomide case, and how long it took to prove it and to get compensation for the victims.
Almost at random, I have picked two other cases. With Paroxetine—I think that is how to pronounce it—GSK held back information because it did not release the tests that did not show a positive benefit. It also kept back tests that showed that Paroxetine increased the chances of children committing suicide, and it took a lot of investigation to get that—
Nusrat Ghani Deputy Speaker and Chairman of Ways and Means
Order. Mr Stringer, I assume you are coming to a conclusion soon.
Graham Stringer Labour, Blackley and Middleton South
I am. I have one sentence. I am sorry; I did not realise I had speaking for so long.
Lastly, Reboxetine is another example of where the information given out to doctors was inadequate because it did not show the negative tests. I use those two examples basically to show that the MHRA should not be enabling these things. It should be much more vigilant, and it should be asking for powers to demand the right to know all the information that drugs companies have before it says those drugs are as safe as they can be.
Nusrat Ghani Deputy Speaker and Chairman of Ways and Means
Order. To enable us to get everyone in, I hope all Members will be mindful of those who are to speak after them.
Christopher Chope Conservative, Christchurch 4:59, 16 January 2025
I shall try to be brief, Madam Deputy Speaker. I follow Graham Stringer by referring to a quote from Hayek’s book, “The Road to Serfdom”. I do not claim credit for identifying it myself; it was quoted in the other place by Lord Hannan of Kingsclere on 15 January in the context of the Football Governance Bill. He was talking about the growth of the administrative state, about which the hon. Gentleman was speaking at the beginning of his speech. Hayek said:
“The delegation of particular tasks to separate bodies, while a regular feature, is yet only the first step in the process by which a democracy…relinquishes its powers”.
That is in chapter 5 of “The Road to Serfdom” from 1944, so not much has changed. The MHRA is an example of what happens if we in this House transfer responsibility to unelected and unaccountable organisations.
It so happens that on the Order Paper for tomorrow is my Covid-19 Vaccine Damage Bill, which is sponsored by a former Attorney General. That Bill calls for an independent review of covid-19 vaccine damage. It calls on the Secretary of State to
“appoint a current or former High Court judge to lead an independent review of disablement caused by Covid-19 vaccinations administered in the United Kingdom and the adequacy of the compensation offered to persons so disabled.”
We know that more than 600 people have already been told by the agency responsible at the Department of Health and Social Care that they have suffered disabilities as a result of covid-19 vaccines. A large number of them, where the disability is in excess of 60%, have been awarded wholly derisory payments of £120,000 each.
My Bill goes on:
“The review must consider…the rates and extent of disablement caused by each type of Covid-19 vaccination offered in the United Kingdom”.
Relevant to this debate, the review must also consider
“the effectiveness of Medicines and Healthcare products Regulatory Agency monitoring of such side effects, and National Health Service and Government responses to such monitoring”, as well as
“the adequacy of compensation offered to persons so disabled”.
There has always been an agreement, basically, that if something goes wrong for people who undertake vaccination voluntarily or are in receipt of other medical products—if they are doing the right thing by the country at large—and they have an adverse reaction, they will be able to look to the Government or the taxpayer to pay them some recompense under the scheme to which I have referred, if causation is established. The trust built by that scheme has been undermined by the long denial of the previous Government—and, to an extent, the current one—that any adverse reactions had been caused by the covid-19 vaccines, other than the most minor disablement. It has also been undermined by the fact that so many people have applied for a review of their cases. Some people—I think more than a thousand—have been waiting more than 18 months for a decision. That shows that this is a low priority for the Government.
I hope that when the Minister responds to the debate, she will be able to explain why the Government will block my Bill again tomorrow. If they were taking this issue seriously, as they should be, they would be open to and supportive of the establishment of an independent review of disablement.
-ENDS-
