Norman Lamb, MP for North Norfolk, has tabled a parliamentary motion calling for urgent action to ensure that women are properly informed of the risks of a drug which can cause severe harm to an unborn child.
Valproate is used for treating epilepsy and bipolar disorder – but has long been known to carry an increased risk of birth defects and developmental disorders in babies when taken by pregnant women. These can include spina bifida, malformations of the face, skull, limbs and organs, lower intelligence, poor speech and language skills, and memory problems.
Following a Europe-wide review, which came about following pressure from Norman Lamb and campaigners during his time as Health Minister, the Medicines and Healthcare Products Regulatory Agency (MHRA) has developed a Toolkit to ensure that women who are being prescribed valproate medicines are better informed about the risks of the drug during pregnancy. The Toolkit includes clearer warning labels on valproate packaging, information booklets for women, and a checklist to ensure that the risks have been properly discussed with the prescribing clinician.
Although the Government says that the Toolkit should have been issued by the MHRA and the manufacturer in February 2016, there have been reports that many clinicians and pharmacies have not received these essential resources – meaning that women across the country remain at risk of taking the medicine without being fully aware of its dangers.
The motion tabled by Norman Lamb calls on the MHRA, UK Government, and NHS England to intervene urgently to ensure that the Valproate Toolkit is received and properly utilised by clinicians and pharmacists nationwide.
Norman Lamb said: “It’s incredibly worrying that this crucial information Toolkit isn’t getting through to women as it should. Valproate can cause severe harm to an unborn child, and the decision to use the medicine should only be made when a woman is fully informed of its risks.
“These risks have been known by regulators for decades. Now that this Toolkit has finally been developed, the Government, MHRA and NHS England must waste absolutely no time in getting to the root of this problem. There has to be accountability.”
Janet Williams and Emma Murphy from IN-FACT (The Independent Fetal Anti Convulsant Trust), which has campaigned for better communication of the risks of using valproate in pregnancy, said:
“IN-FACT worked closely with the MHRA to agree and disseminate the Valproate Toolkit. But because the MHRA has only sent the toolkit to pharmacies and surgeries that subscribe to its alerts system, it seems that its distribution has been left largely in the hands of the drugs company.
“This has caused system failure with this vital information not reaching women of child-bearing age, and therefore around 30,000 women prescribed valproate unable to make that all-important informed choice.”
EDM 83: VALPROATE TOOLKIT
That this House notes with concern that the medicine valproate, which is used for the treatment of epilepsy and bipolar disorder, can seriously harm an unborn child when taken during pregnancy, including increased risk of malformations and developmental disorders; welcomes the development of a valproate toolkit to aid communication of the risks of valproate in pregnancy, including a warning on package labelling, a checklist for discussion between prescribers and patients, a reminder card and information booklet for women, and a booklet for healthcare professionals; further notes that the toolkit was disseminated by the Medicines and Healthcare products Regulatory Agency (MHRA) and the valproate manufacturer, Sanofi, in February 2016; expresses concern at reports that many pharmacists and clinicians have not received the toolkit, potentially leaving many women ill-informed of the severe risks of the medicine; and urgently calls on the Government, the MHRA and NHS England to work together to ensure that the toolkit is effectively disseminated and utilised across the country so that all women being prescribed valproate are fully informed of the risks to an unborn child.
Norman Lamb, MP for North Norfolk, is taking action with fellow East Anglia MPs Dr. Dan Poulter (Central Suffolk and North Ipswich) and Peter Aldous (Waveney) to demand a change in the law to improve support for benefits recipients who lack the mental capacity to manage their financial affairs.
The Mental Capacity Act 2005 established the Court of Protection to provide protection for individuals who lack mental capacity to make decisions about their own lives. This can include the appointment of a Deputy, who is authorised to make decisions for those unable to manage their financial affairs.
However, the Code of Practice to the Mental Capacity Act currently advises that people who are receiving benefits do not generally require the assistance of a Deputy – making it extremely difficult for these people to manage their finances, pay a mortgage, and authorise a range of basic day-to-day payments.
Norman Lamb, together with Dan Poulter and Peter Aldous, has tabled a parliamentary motion calling for a change in the Code of Practice to allow the appointment of Deputies for people who are in receipt of benefits.
The Professional Deputy Service scheme in Suffolk currently offers a Deputy service to benefits recipients, allowing them ‘to manage their finances and to live as independently as possible’. This has had a huge impact on the lives of many vulnerable people in the county.
Norman Lamb MP said: “I’m very pleased to work with Dan Poulter and Peter Aldous to highlight this unfairness. In its current form, the Code of Practice to the Mental Capacity Act means that many people who are already in a vulnerable position miss out on crucial support for managing their finances.
"We should always aim to learn from best practice, and the Professional Deputy Service in Suffolk has shown the difference that the appointment of a Deputy can make to the lives of people who are receiving benefits. I hope that the Government will recognise the importance of this and implement the changes to the Code of Practice without delay.”
Dr. Dan Poulter MP said: “I am very happy to jointly sponsor this Early Day Motion (EDM) and welcome the opportunity to raise this issue in Parliament. This is the first in a series of steps to address an undesirable and unintentional consequence of the Mental Health Act.”
Peter Aldous, MP for Waveney said: “It is important that there is an amendment to the Mental Capacity Act 2005. The work of the Professional Deputy Service shows a clear need for their services to help those most vulnerable who struggle to look after their own finances.”
EDM 86: APPOINTMENT OF DEPUTIES FOR BENEFITS RECIPIENTS
That this House notes that Patients of the Court of Protection, people who lack capacity to manage their affairs, can have a Deputy appointed who can manage their affairs, including the ability to make speedy decisions on authorising payment for adaptations to the home and many other day-to-day expenditures; further notes that the Code of Practice to the Mental Capacity Act 2005 advises that people receiving benefits do not usually need a Deputy; notes the innovative scheme in Suffolk, run by the Professional Deputy Service, which offers a Deputy service to benefits recipients; recognises that this has had a very positive impact on people's lives; further recognises that without a Deputy decision-making on vital expenditure will usually be delayed; and calls on the Ministry of Justice to change the Code of Practice to ensure that those receiving benefits can be afforded the same opportunities and decision-making service in regard to their financial affairs that others, with more money, already enjoy.
The Queen’s Speech fails to address some of the biggest challenges facing the country, North Norfolk MP Norman Lamb has warned in a House of Commons debate on ‘Defending Public Services’.
Mr. Lamb said that the safety of patients is being put at risk by the immense financial pressure facing the NHS, three days after NHS trusts announced a record deficit of £2.45bn. He highlighted the “massive consequences” of the underfunding of mental health and cuts to preventive services, including immense pressure on hospitals and an increase in the scandalous practice of people with mental illness being shunted around the country in search of a bed.
Mr. Lamb also pointed to the high number of people with mental illness in prisons, and a spike in prison suicides, as a “fundamental failure of public policy”. Challenging the Government to “radically reduce the number of people who end up inappropriately in our prisons”, he repeated his call for end to the so-called ‘war on drugs’, a legalised and regulated cannabis market, and a greater focus on mental health treatment orders as an alternative to prison sentences.
You can read the full speech here.
Speaking after the debate, Norman Lamb said:
“The Queen’s Speech was a real missed opportunity to address these critical challenges.
“Every day we are confronted with stark new evidence of the pressures facing health and care services. As well as more funding, there is now an overwhelming need for all parties to come together to design a new long-term settlement for the system.
“We also have to stop unfairly criminalising young people and gifting billions of pounds to organised crime through our arcane drugs laws. Britain is behind the curve on this. I strongly believe we must follow the more enlightened and evidence-based policies adopted in countries such as Canada, Portugal and Uruguay, with a focus on safety and public health through regulation rather than dishing out criminal records and prison sentences.”
100 MPs have signed a motion calling for legal recognition for people who do not associate with a particular gender, tabled by North Norfolk MP Norman Lamb.
Early Day Motion 660 recognises that people whose identities are neither male nor female are “compromised and diminished” by UK passport policy, which currently requires each person’s passport to be marked with an ‘M’ or ‘F’.
The motion “urges that the Government and HM Passport Office make non gender-specific X passports available in the UK to people who do not identify with a particular gender”.
A growing number of countries already allow non gender-specific passports to be issued to applicants when neither ‘M’ nor ‘F’ apply; including Australia, New Zealand, Malta, Nepal and India.
The Women and Equalities Select Committee's 'Transgender Equality' report, published in January 2016, also recommended that “The UK must follow Australia’s lead in introducing an option to record gender as “X” on a passport. If Australia is able to implement such a policy there is no reason why the UK cannot do the same. In the longer term, consideration should be given to the removal of gender from passports.”
Norman Lamb MP, who is re-tabling the motion for the new parliamentary session 2016-17, said:
“Reaching this milestone shows the strength of support for the rights of non-gendered people. This is a simple fight for equality. There is no reason why gender should be specified on a passport, and to force people to choose between two binaries is discriminatory and archaic.
“Few parliamentary motions receive the backing of 100 MPs. This achievement is testament to the importance of this issue, and to the tireless and inspiring work of campaigners like Christie Elan-Cane.
“I will continue to throw my full weight behind this campaign, and look forward to giving a voice to people who do not associate with a particular gender in the new parliamentary session.”
Christie Elan-Cane, NON-GENDERED – Fighting for Legal Recognition, said:
“That so many Members of Parliament have openly pledged their support for this issue is a monumental achievement given the issue was completely under the radar when I first approached my former MP in 2005. The issue is not controversial to those of us who define without gender, neither male nor female, whose lives are eroded by social invisibility and a lack of enforceable civil rights.
"Legitimate identity is a fundamental human right and governing authorities cannot just continue ignoring our existence indefinitely. The issue will not go away. A growing number of people are resisting enforced and inappropriate gendered categorisation. Provision of ‘X’ Passports is just the beginning in our fight for equality and fair treatment.”
Full text of EDM 660: LEGAL RECOGNITION FOR PEOPLE WHO DO NOT ASSOCIATE WITH A PARTICULAR GENDER
That this House recognises the support expressed during the last parliamentary session to address the issues faced by people whose identities are neither male nor female; believes that people are compromised and diminished as a result of inappropriate gender references on their personal identity information; acknowledges that all passports issued by HM Passport Office are currently gender-specific and it is therefore not possible to obtain a British passport that contains no reference to gendered identity; understands that the International Civil Aviation Organisation standard specification for machine-readable travel documents (ICAO Document 9303) permits X (unspecified) alongside F (female) and M (male) under a mandatory sex category; notes that citizens of Australia and New Zealand are able to obtain a non gender-specific X passport and that India, Nepal and Pakistan make provision for their citizens when neither M nor F are appropriate; further believes that similar provision is needed in the UK where current discriminatory policy denies non-gendered and bi-gendered people a legitimate identity; and therefore urges that the Government and HM Passport Office make non gender-specific X passports available in the UK to people who do not identify with a particular gender.
The UK Statistics Authority this week issued a damming verdict on the Vote Leave campaign’s misleading claims that over £350 million a week is sent by the UK to Europe, following a complaint by Norman Lamb, Liberal Democrat MP for North Norfolk.
In a letter to the Chair of the UK Statistics Authority, Sir Andrew Dilnot, Norman Lamb pointed out that the £350 million figure is false because it includes funds which are returned to the UK, but also the UK rebate, which is in fact never sent to the EU.
Responding to the letter, Sir Andrew Dilnot has described the figures used by Leave campaigners as "lacking clarity" and "misleading".
Commenting, Norman Lamb said:
“This is a damning indictment of the Leave campaign. There are no official reputable bodies in the country or internationally who have backed their bogus claims.
“It is yet another example of their desperate attempts to mislead people throughout the referendum.
“They must withdraw any campaign material with this misleading and deliberately unclear figure immediately.
“The British people deserve better.”
The response from Sir Andrew Dilnot can be read here.
In his original letter, Norman Lamb wrote:
As you will have seen, Vote Leave, the officially designated campaign for Britain to leave the European Union, has repeatedly claimed that over £350 million a week, or £18.8bn a year, is sent by the UK to Europe.
Vote Leave claim that if Britain were to leave Europe this money could be repatriated and spent in its entirety on the NHS.
This claim has been repeatedly used by the campaign, even though it has been shown to be inaccurate by independent fact-checkers. Just today the BBC has said, “Leaving the EU would not give the UK an extra £350 million a week to spend on the NHS”.
The £350 million figure is false because it includes funds which are returned to the UK, but also the UK rebate, which is in fact never sent to the EU.
The Institute for Fiscal Studies (IFS) has contradicted the figure, stating that the net contribution it is £5.7 billion, not £18.8 billion as Vote Leave claims. The IFS have also said that using contribution figures “without the UK’s rebate having been deducted” is “less sensible”.
Using European Commission figures, the average annual UK net contribution 2010-2014 was £7.1bn, clearly far short of the claims made by Vote Leave.
The Office of National Statistics show an average UK contribution 2010-2014 of £8.9bn.
This evidence conclusively shows that the £350 million figure is factually incorrect and I believe it is being used to purposefully mislead.
I am writing to request that you please confirm that the Vote Leave claim that £350 million is sent to the EU is factually incorrect.
Our concern is that this is being presented as an official statistic, when in fact there is clear and independent evidence to show that it is wrong.
Given the UK Statistics Authority’s role to “promote and safeguard the production and publication of official statistics that serve the public good” and to “ensure good practice in relation to official statistics”, I believe this falls within your remit.
I hope that you will confirm that this is this figure is incorrect.
Norman Lamb MP
Norman Lamb, MP for North Norfolk and Liberal Democrat spokesperson for health, has advanced his campaign for better disability awareness training for security staff in a constructive meeting with the Minister for Disabled People, Justin Tomlinson.
The meeting took place following strong cross-party support for a parliamentary motion, tabled by Norman Lamb, highlighting the lack of focus on disability in training specifications for security staff, and the resulting discrimination faced by people with disabilities from door staff outside bars and clubs. The motion supports ‘Enhance the UK’ charity’s campaign for proper disability awareness training to be given to all security and door staff. Jennie Williams and Gary Mazin attended the meeting on behalf of the charity.
In the meeting at the Department of Work and Pensions, the Minister agreed to encourage the Security Industry Association (SIA), which regulates the private security industry in the UK, to engage with charities like Enhance the UK to design better disability awareness training programmes.
Norman Lamb has now written to the Chief Executive of the Local Government Association (LGA), Mark Lloyd, requesting a meeting to discuss the role that local authorities could play in driving change. This might include requiring a better standard of disability awareness training for security staff when granting entertainment licenses to nightclubs and bars.
Speaking after the meeting, Norman Lamb said:
“We simply cannot tolerate a society where people suffer discrimination because of their disability. Security staff must be given the training they need to understand disability, and treat people who have disabilities with respect as equal citizens.
“I’m pleased that the Minister has agreed to meet with the SIA to discuss this further, and I hope to secure a meeting with the LGA to explore how local authorities can make a difference in ensuring that local security staff are properly trained in disability awareness. Local authorities could, for instance, force all venues requiring an entertainments' licence to have security staff given this training.
“I will keep fighting alongside Enhance the UK and other organisations to make sure we see progress on this issue and achieve genuine equality for people with disabilities.”
Gary Mazin, from Enhance the UK, said:
“After an altercation when I was pushed by a doorman for having a guide dog, and receiving numerous other messages about incidents involving door security staff and disabled access, ‘Enhance the UK’ discovered that there are some glaring flaws in the way that security staff are given training, particularly with regards to disability awareness.
“Thanks to the help of Norman tabling the motion, we were able to discuss this in a positive meeting with the Minister.
“It’s extremely important that anyone working in the hospitality or service industry must have disability awareness training that isn’t just tick box or reams of legal text. What they need is training that gives practical examples in a simple to understand format. I hope the SIA and local authorities will take more responsibility for the quality and consistency of these training standards, to improve the lives of disabled people when accessing venues across the UK.”
On Wednesday 23rd March, Norman Lamb, MP for North Norfolk and Liberal Democrat Spokesperson for Health, presented his Ten Minute Rule Bill to introduce a legal and regulated cannabis market in the UK. The full text of his speech is as follows:
"Mr Speaker, I beg to move that leave be given to bring in a Bill to amend the Misuse of Drugs Act 1971 to provide for the lawful production, packaging, marketing, sale, purchase, possession and consumption of herbal cannabis in specific circumstances by certain persons; and for connected purposes.
"It is long overdue that we call time on the so-called war on drugs launched 45 years ago by the then President of the United States of America, Richard Nixon. Since then, billions of dollars every year have gone straight into the hands of organised crime, Governments have been corrupted by the drugs trade, thousands upon thousands of people have lost their lives in countries such as Mexico and Colombia, profits from the drugs trade have funded terrorism—as recognised by the United Nations Security Council—and thousands of our fellow citizens every year are criminalised for using drugs. This has been a catastrophic failure.
"There is an urgent and compelling case for a more rational approach. Thankfully, around the world, sense is breaking out. In the United States, Colorado, Alaska, Oregon, Washington and the District of Columbia have all legalised cannabis, introducing a regulated market. Uruguay has done the same thing. In Europe, Portugal has decriminalised drug use—a move that now has cross-party support from right to left—and is instead taking a health-based approach. Drug-related deaths and sexually transmitted diseases due to drug use have decreased dramatically as a result of the change.
"And now in Canada, the new Liberal Government have been elected on a manifesto that commits them to legislating for the legalisation of cannabis. My plea is that in this country we should base our approach on evidence and on reducing harms rather than on fear and anxiety about public reaction. My sense is that the public are, in many respects, way ahead of the politicians on this subject.
"My starting point is that I am instinctively hostile to drugs, legal and illegal. Tobacco kills about 100,000 people in our country every year. Alcohol causes untold damage to very many families, not least because of its association with domestic violence. It also leads to violence on our streets. The most potent strains of cannabis also carry health risks, including psychosis and memory loss, but do we really think that we best protect people by leaving the supply of cannabis in the hands of organised crime? No criminal is interested in people’s welfare. When someone chooses to buy cannabis, they have no idea what they are buying or how potent the product is.
"So-called skunk is widely available on the criminal market in every town and city across our country. Any idea that we can protect people by keeping it illegal is fanciful. No one now believes that we can actually win the war on drugs, so a public policy intended to protect people from harm is achieving precisely the opposite, and we are putting billions of pounds every year into the pockets of organised crime. What a spectacularly stupid self-defeating policy!
"Some people raise a legitimate anxiety about people moving from cannabis to harder, more dangerous drugs, but the risk is self-evidently far higher when people buy from criminals, who have a direct interest in persuading them to do just that. On top of that, we criminalise tens of thousands of people every year for the use of cannabis, blighting their careers, damaging their life chances and restricting their ability to travel. Many people with mental ill health resort to cannabis as a relief from the pain they suffer, and then we criminalise them. What a cruel, unjust policy that is. We criminalise multiple sclerosis sufferers and many others who use cannabis to relieve pain, so I strongly support the 'End Our Pain' campaign.
"There is real hypocrisy here. While those people are knocked back by criminal convictions, others, usually the more privileged, go on to build successful careers. How many members of the Government have smoked cannabis while maintaining their support for the conviction of their fellow citizens? The Prime Minister was a reformer. It has also been reported that he and others were caught smoking cannabis at Eton. He has gone on to do quite well.
"Having signed up to a Select Committee on Home Affairs report in 2002 calling for the then Labour Government to initiate a discussion of alternative ways, including the possibility of legalisation and regulation, to tackle the global drugs dilemma, he retreated once elected Conservative leader and now seems implacably opposed to reform. Why has the Prime Minister changed his mind? Why continue to allow our fellow citizens to be put at risk, with the possibility of criminal conviction, for doing exactly what he did?
"My party, the Liberal Democrats, commissioned an independent expert panel to advise on a more rational approach. The panel was made up of leading experts and included a retired chief constable of Cambridgeshire, Tom Lloyd, and the serving chief constable of Durham, Mike Barton. They know better than anyone the drain on police time caused by dealing with drug possession offences. The report, published on 8 March, is rational, wise and balanced. It points to a different approach, and the Bill seeks to implement that approach.
"The proposed framework is based on the primary goal of protecting and enhancing public health and community safety, with a particular focus on the health and wellbeing of vulnerable and marginalised groups. It is guided by evidence and deliberately cautious and proposes regular reviews. It sets out plans to establish a cannabis regulatory authority. Producers and products and sales would be licensed. Cannabis would be sold through licensed outlets. There would be mandatory provision of health advice to consumers at the point of sale. Cannabis would be sold in plain packaging.
"There would be a minimum age of 18 for the purchase and consumption of cannabis. Critically, there would be controls on potency, with a minimum requirement of 4% cannabidiol, which is important for reducing the risk of dependence, psychosis and memory loss. Of course, no such safeguards are available on the existing criminal-controlled market.
"The expectation is that sales could raise up to £1 billion in tax. There would be significant savings of police time, enabling them to focus on serious and violent crime. Limited amounts of home growing for personal use would be permitted, with an enforceable limit of plants per household. The scheme would also permit small-scale licensed production for membership-based cannabis social clubs similar to those that have existed for years in Spain. They would have to be operated on a not-for-profit basis and would be subject to conditions, including limiting the size of clubs to fewer than 100 adult members and limiting per-member production and supply. It would remain a serious criminal offence to drive while impaired by cannabis.
"I understand why many people’s first instinct might be to fear the consequences of legalising cannabis, yet thinking through the disastrous consequences of maintaining prohibition of this drug—the profiting of criminals, the health risks resulting from people not knowing what they are buying, the criminalising of so many people, including those with mental ill health and multiple sclerosis—leads to the recognition that a new, more rational approach is desperately needed."
Liberal Democrat Health Spokesperson Norman Lamb MP this week proposed the biggest shake up to UK drugs laws in the last 50 years.
The bill, presented to Parliament on Wednesday (23rd March), proposed the introduction of a legal cannabis market in the UK.
It follows the publication of a report by an independent panel of experts which made a series of practical recommendations for how a regulated cannabis market could work. The Liberal Democrats formally adopted cannabis legalisation as party policy at their spring conference earlier this month.
Norman Lamb has said that he hopes the bill "start an open and mature discussion about the UK's drugs laws".
The bill has cross-party support, and is co-sponsored by Tim Farron, Nick Clegg, Tom Brake, Alistair Carmichael, Caroline Lucas (Green), Paul Flynn (Labour), Michael Fabricant, Crispin Blunt, and Peter Lilley (all Conservatives).
Commenting on the eve of the bill, Norman Lamb said: “I’ve argued for a long time that our laws on drugs are outdated, harmful and well overdue for reform.
“My biggest concern is that the risk that prohibition poses to public health. No criminal is interested in your welfare, and no drug is made less harmful when bought from organised crime networks. People have no idea of the strength of safety of what they’re buying.
“The so-called ‘war on drugs’ diverts valuable resources and police time which could be better used tackling far more harmful crimes than people carrying small amounts of cannabis for personal use. And thousands of people each year receive convictions for drug possession which blight their employment prospects for the rest of their lives.
“A regulated market in the UK will take profits out of the hands of organised crime and reduce both health and social harms. By bringing this bill to Parliament, I hope to kick-start an open and mature discussion about the UK’s drug laws which is long overdue.
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Norman Lamb, MP for North Norfolk and the Liberal Democrat spokesperson for health, has urged NHS England to provide funding for the ground-breaking HIV prevention treatment Pre-Exposure Prophylaxis, or PrEP.
Despite huge improvements in the management of HIV in recent years, a total of 6,151 people in the UK were newly diagnosed with the virus in 2014. Studies have shown that PrEP is extremely effective at reducing the risk of infection in people who are at high risk of getting HIV, and the PROUD study last year suggested that the treatment can reduce infection by 86%.
However, NHS England said this week that it will not provide access to PrEP nationally, arguing that HIV prevention services are the responsibility of local authorities. Instead, it announced a further two-year study of PrEP at "test sites", restricting access to the treatment to around 500 men at high risk of infection.
Thousands of people are now set to miss out on the drug, which is why Norman Lamb has tabled a motion in Parliament calling on the Government to intervene and ensure that this essential treatment is made available on the NHS as soon as possible.
The full text of the motion is as follows:
That this House raises serious concerns over the recent decision by NHS England to delay the national roll-out of Pre-Exposure Prophylaxis (PrEP) for HIV; notes that this decision was made despite overwhelming evidence of the effectiveness of PrEP in reducing infection with HIV in high-risk groups, including the PROUD study which showed that PrEP reduced the risk of infection by 86 per cent; further notes that HIV transmission rates are increasing not only in the men who have sex with men population but also among BME communities and heterosexual women; affirms that PrEP, which is already available in other countries such as France, the US, Canada, Kenya and Israel, is a crucial part of the armoury in the fight against HIV and could prevent 7,400 new cases of the infection by 2020; believes that NHS England's announcement of PrEP test sites over the next two years is unnecessary in light of the clinical evidence available, and is concerned that this may be intended to avoid acceptance of responsibility for commissioning HIV prevention treatments rather than local authorities; further believes that, as an essential treatment, responsibility for commissioning PrEP should lie with NHS England rather than local authorities; and urges the Government to intervene as a matter of urgency to ensure that NHS England takes the steps necessary for PrEP to be considered as part of the next annual CPAG prioritisation process so that all high-risk groups are able to access the treatment as soon as possible.