Day: August 2, 2016

NHS England to appeal judgment brought before the courts by NAT which says interpretation of law by NHS England was incorrect.

The High Court today ruled NHS England acted unlawfully in withdrawing PrEP, a game-changing drug preventing transmission of HIV, from its decision-making process.

Following 18 months of preparation, in March this year, without notice, NHS England suddenly abandoned its work on PrEP.

NAT considered it had no option but to challenge this through judicial review.

Today the court heard that NHS England’s interpretation of the law was incorrect.  PrEP is urgently needed and has been shown to be cost-effective.  NAT has always believed that there is no legal impediment to PrEP being commissioned by NHS England and the court agreed.

Deborah Gold, Chief Executive of NAT, said: “This is fantastic news. It is vindication for the many people who were let down when NHS England absolved itself of responsibility for PrEP.  The judgment has confirmed our view – that it is perfectly lawful for NHS England to commission PrEP.  Now NHS England must do just that. 

“Over 4,000 people are getting HIV every year in the UK – we desperately need further prevention options to add to condom use.  PrEP works.  It saves money and it will make an enormous difference to the lives of men and women across the country who are at risk of acquiring HIV.  The delay to commissioning PrEP is both unethical and expensive.”

In his judgement Mr Justice Green wrote: “No one doubts that preventative medicine makes powerful sense. But one governmental body says it has no power to provide the service and the local authorities say that they have no money.  The Clamant is caught between the two and the potential victims of this disagreement are those who will contract HIV/AIDs but who would not were the preventative policy to be fully implemented.”

He goes on to conclude that in all the possible scenarios that were explored in the judicial review, NHS England does have the power to commission PrEP.

NAT say they are “enormously disappointed” that NHS England has decided to appeal this judgment, especially given the wide-ranging and well-reasoned arguments it contains.

The appeal will further delay clarity in this area, and mean that any potential commissioning of PrEP will not take place for months. Following this decision, there will now be a 30-day public consultation on PrEP, which should start almost immediately, and an NHS England committee will consider the case for commissioning it, but final announcements and actual commissioning will be contingent on the outcome of the appeal.

Responding to the judgement, Cllr Teresa O’Neill OBE, London Councils’ Executive member for health, said: “We are delighted that the High Court has ruled that NHS England does have the power to commission PrEP as part of its broader preventative role and in line with its provision of PEP, as we have maintained all along. 

“We hope the NHS now focusses on making PrEP available as part of local prevention programmes as soon as possible.

“London boroughs are committed to playing their part in HIV prevention using the fullest range of options and this must include being able to work with NHS England to offer PrEP, as well as promoting HIV testing and condom use. We look forward to getting on with the important task of reducing HIV in London in partnership with the NHS and the voluntary sector.”

Ian Green, Chief Executive of Terrence Higgins Trust, added: “We are relieved that, at last, we know who is legally responsible for making the game-changing HIV prevention treatment PrEP available to people who are at risk.

“It is a vindication for the community after a long fight –  but it should never have come to this.  Because of the mess and delays created by NHS England, people at risk of HIV have spent the past 18 months fighting to be heard, meanwhile 17 people have been diagnosed with HIV with every day that has passed.

“The matter has become urgent. People we know to be at very high risk of HIV who are currently accessing PrEP will be coming off the PROUD trial this month and unless NHS England acts rapidly, it is only a matter of time before some of these people become HIV positive. PrEP must be prioritised and made available now.

“We are grateful to NAT for taking this to court and stand by the HIV community in celebrating that the battle has been won, but we cannot call this a true victory until the day that people at highest risk finally have access to this groundbreaking pill that will protect them from HIV.”

Peter Kyle, MP for Hove and Portslade, said: “It is absurd and disgusting that NHS England are appealing this decision. Evidence and expert opinion is conclusive that PrEP works, it keeps people safe from infection and it lowers the cost of HIV treatment on the NHS. I hope government sees sense before wasting further money on this ludicrous appeal that not only makes no sense but is an offence to the gay community.”

Councillor Phélim Mac Cafferty, Convenor of the Green Group of councillors, said: “I’m pleased that the Royal Court of Justice ruling this week will force the NHS to rethink its stance on HIV Pre-exposure prophylaxis (PrEP). It’s disappointing the NHS is seeking to appeal rather than moving forward with funding PreP.

“This drug has the potential to transform lives and save millions in treatment costs to the taxpayer. It is only right that it be considered as part of a wider programme of HIV prevention.

“At a time of unprecedented Conservative government cuts to council budgets, any decision by the NHS to pass the buck of funding to local Councils would result in very few councils being able to afford to fund PreP.  In areas like Brighton and Hove because of the growing incidence of HIV, we need a strong and lasting settlement on PrEP. We believe that can only come from it being funded directly through existing or future NHS funds, and not susceptible to the massive cuts hitting our council.

“That’s why it’s essential that the NHS plays its part and reviews how it can best integrate PreP into existing prevention work. And why government and the NHS must commit to funding PreP from additional NHS funding.”