Medical Technology Inquiry

By Richard Lewis at August 24th, 2012

Guest blog by Mark Drakeford AM

The National Assembly for Wales’s Health and Social Care Committee is planning to conduct a new inquiry on appraisal of and access to medical technologies in Wales.

Evidence-gathering on this issue may commence later this year but the schedule is dependent on the amount of legislation the Committee must first consider.

To help shape the focus of this potential inquiry, Committee Chair, Mark Drakeford AM, is seeking views on what aspects of medical technology should be considered.

The All Wales Medicines Strategy Group (AWMSG) exists to advise the Welsh Government on strategic medicines management and prescribing. The Group has a three-fold responsibility:

-          to advise the Welsh Government of future developments in healthcare to assist with strategic planning;

-          to advise on a prescribing strategy for Wales; and

-          to provide timely, independent advice on new medicines.

The AWMSG works with and alongside the National Institute for Health and Clinical Excellence (NICE) to ensure that the people of Wales have equal access to new and existing medicines that are deemed clinically and cost effective.

But there is no such body in Wales charged with providing similar guidance for medical technology, which may include devices, diagnostic techniques and surgical procedures.

This was one of the issues highlighted during a seminar hosted by the Health and Social Care Committee, and attended by a number of healthcare professionals. It prompted the obvious question of ‘why not?’ from my committee colleagues.

The Minister for Health and Social Services, Lesley Griffiths AM, recently attended a National Assembly committee meeting at the Senedd and was asked about the provision of medical technology guidance and whose responsibility it was.

The Committee was told Wales was unlikely to have the capacity to undertake full technology reviews in the way the National Institute for Health and Clinical Excellence’s (NICE) Medical Technologies Advisory Committee can. We were also told that some responsibilities could come under the remit of the Welsh Scientific Advisory Committee, which provides expert advice on science, technology, engineering and mathematics issues to the Welsh Government’s Chief Scientific Adviser, while others could fall within the domain of the Welsh Health Specialised Services Committee.

Research exists, including The Work Foundation’s ‘Adding Value: The Economic and Societal Benefits of Medical and Technology, which suggests Wales is lagging behind other UK nations in terms of the use of some devices. We would like to know whether this is actually the case and, if so, why.

For these reasons, the Health and Social Care Committee is planning to conduct a short, focused inquiry on access to medical technologies in Wales but, first, we would like to establish what the scope of the inquiry should be.

So we are consulting on the terms of reference and hope to gather expert opinions on which particular aspects of accessing medical technologies we should be focusing our efforts.

In particular, we would welcome comments on:

- The uptake of medical technology in Wales and the possible barriers to effective new (non-drug) treatments being more accessible to patients;

- The current appraisal processes for new medical technologies, including medical devices, diagnostic techniques and surgical procedures;

- And, the decision-making process in NHS Wales on funding new medical technologies/treatments.

Comments should arrive by Friday 5 October and can either be emailed to HSCCommittee@Wales.gov.uk or by writing to: Clerk to the Health and Social Care Committee, National Assembly for Wales, Cardiff Bay, Cardiff, CF99 1NA.

I should stress that, at this stage, this is an opportunity to comment on the scope of the inquiry only, not to submit formal evidence. It should also be noted that the timetable for this inquiry is dependent on the amount of legislation submitted to the Committee for consideration.

We hope to issue a further call for more detailed submissions later this year once the terms of reference for the inquiry have been established and made public. It is likely the committee will begin taking oral evidence on this matter in early 2013.

Mark Drakeford is the Assembly Member for Cardiff West and the Chair of the National Assembly’s Health and Social Care Committee. He is a former adviser to the Welsh Government on health and social policy and is a Professor of social policy at Cardiff University.

 

Mae Pwyllgor Iechyd a Gofal Cymdeithasol Cynulliad Cenedlaethol Cymru yn bwriadu cynnal ymchwiliad newydd i’r broses o werthuso technolegau meddygol yng Nghymru a mynediad at y technolegau hyn.

Mae’n bosibl y bydd y gwaith o gasglu tystiolaeth ar y mater hwn yn dechrau yn ddiweddarach yn y flwyddyn, ond mae’r amserlen yn dibynnu ar faint o ddeddfwriaeth y mae’n rhaid i’r Pwyllgor ei hystyried yn gyntaf.

Er mwyn helpu i lywio ffocws yr ymchwiliad posibl hwn, mae Mark Drakeford AC, Cadeirydd y Pwyllgor, yn ceisio barn ar ba agweddau ar dechnoleg feddygol y dylid eu hystyried.

Mae Grŵp Strategaeth Feddyginiaethau Cymru Gyfan yn bodoli i roi cyngor i Lywodraeth Cymru ar reoli meddyginiaethau yn strategol a phresgripsiynu. Mae gan y Grŵp dri phrif gyfrifoldeb:

-          rhoi cyngor i Lywodraeth Cymru ynghylch datblygiadau gofal iechyd yn y dyfodol i gynorthwyo â’r gwaith o gynllunio strategol;

-          rhoi cyngor ar strategaeth bresgripsiynu i Gymru; a

-          rhoi cyngor amserol ac annibynnol ar feddyginiaethau newydd.

Mae Grŵp Strategaeth Feddyginiaethau Cymru Gyfan yn gweithio ar y cyd â’r Sefydliad Cenedlaethol dros Iechyd a Rhagoriaeth Glinigol, ac ochr yn ochr â’r Sefydliad, i sicrhau bod gan bobl Cymru fynediad cyfartal at beiriannau newydd a pheiriannau sy’n bodoli eisoes y bernir eu bod yn effeithiol yn glinigol ac o ran cost.

Fodd bynnag, nid oes corff o’r fath yng Nghymru sydd â’r cyfrifoldeb o gynnig cyfarwyddyd tebyg ar dechnoleg feddygol, a all gynnwys dyfeisiau, technegau diagnostig a gweithdrefnau llawfeddygol.

Dyma un o’r materion a nodwyd yn ystod seminar a gynhaliwyd gan y Pwyllgor Iechyd a Gofal Cymdeithasol, lle’r oedd nifer o weithwyr gofal iechyd proffesiynol yn bresennol. Yn sgîl y drafodaeth hon, cafodd y cwestiwn amlwg, ‘pam lai?’, ei ofyn gan fy nghyd-aelodau pwyllgor.

Roedd Lesley Griffiths AC, y Gweinidog Iechyd a Gwasanaethau Cymdeithasol, yn bresennol yng nghyfarfod un o bwyllgorau’r Cynulliad Cenedlaethol yn y Senedd a gofynnwyd iddi am y ddarpariaeth o gyfarwyddyd ynghylch technoleg feddygol a chyfrifoldeb pwy oedd darparu’r cyfarwyddyd hwn.

Clywodd y Pwyllgor nad yw’n debygol bod gan Gymru’r capasiti i gynnal adolygiadau llawn o dechnoleg yn yr un modd ag y mae Pwyllgor Cynghori ar Dechnoleg Feddygol y Sefydliad Cenedlaethol dros Iechyd a Rhagoriaeth Glinigol yn gallu ei wneud. Clywsom hefyd y gallai rhai cyfrifoldebau ddod o dan gylch gorchwyl Pwyllgor Ymgynghorol Gwyddonol Cymru, sy’n darparu cyngor arbenigol ar faterion ynghylch gwyddoniaeth, technoleg, peirianneg a mathemateg i Brif Gynghorydd Gwyddonol Llywodraeth Cymru, ac y gallai materion eraill ddod o dan awennau Pwyllgor Gwasanaethau Iechyd Arbenigol Cymru.

Mae gwaith ymchwil yn bodoli, gan gynnwys cyhoeddiad gan y Sefydliad Gwaith, ‘Adding Value: The Economic and Societal Benefits of Medical Technology, sy’n awgrymu bod Cymru ar ei hôl hi o gymharu â gwledydd eraill y DU o ran defnyddio rhai dyfeisiau. Hoffem wybod a yw hyn yn wir ac, os felly, pam.

Am y rhesymau hyn, mae’r Pwyllgor Iechyd a Gofal Cymdeithasol yn bwriadu cynnal ymchwiliad byr a chyda ffocws pendant i fynediad at dechnolegau meddygol yng Nghymru ond, yn gyntaf, hoffem gadarnhau beth ddylai fod cylch gwaith yr ymchwiliad.

Felly, rydym yn ymgynghori ar y cylch gorchwyl a gobeithiwn gasglu safbwyntiau arbenigol ar ba agweddau penodol o ran cael mynediad at dechnolegau meddygol y dylwn fod yn canolbwyntio ein hymdrechion arnynt.

Yn benodol, byddem yn croesawu sylwadau ar y canlynol:

- faint o dechnoleg feddygol sy’n cael ei defnyddio yng Nghymru a’r rhwystrau posibl sy’n atal cleifion rhag cael mynediad haws at driniaethau newydd ac effeithiol (ac eithrio cyffuriau);

- y prosesau gwerthuso cyfredol ar gyfer technolegau meddygol newydd, gan gynnwys dyfeisiau meddygol, technegau diagnostig a gweithdrefnau llawfeddygol;

- a’r broses gwneud penderfyniadau yn y GIG o ran ariannu technolegau/triniaethau newydd.

Dylai sylwadau gyrraedd erbyn dydd Gwener 5 Hydref. Gellir eu cyflwyno naill ai drwy anfon e-bost at PwyllgorIGC@cymru.gov.uk neu drwy ysgrifennu at: Clerc y Pwyllgor Iechyd a Gofal Cymdeithasol, Cynulliad Cenedlaethol Cymru, Bae Caerdydd, Caerdydd, CF99 1NA.

Ar hyn o bryd, dylwn bwysleisio mai dim ond cyfle i fynegi barn ar gylch gwaith yr ymchwiliad yw hwn, ac nid cyfle i gyflwyno tystiolaeth ffurfiol. Dylid hefyd nodi bod yr amserlen ar gyfer yr ymchwiliad hwn yn dibynnu ar faint o ddeddfwriaeth sy’n cael ei chyflwyno i’r Pwyllgor i’w hystyried.

Rydym yn gobeithio cyhoeddi galwad pellach am gyflwyniadau mwy manwl yn ddiweddarach yn y flwyddyn ar ôl cadarnhau a chyhoeddi cylch gorchwyl yr ymchwiliad. Mae’n debygol y bydd y Pwyllgor yn dechrau clywed tystiolaeth ar lafar ar y mater hwn ddechrau flwyddyn nesaf.

Mark Drakeford yw’r Aelod Cynulliad dros Orllewin Caerdydd a Chadeirydd Pwyllgor Iechyd a Gofal Cymdeithasol y Cynulliad Cenedlaethol. Mae’n gyn-gynghorydd i Lywodraeth Cymru ar iechyd a pholisi cymdeithasol ac yn Athro polisi cymdeithasol ym Mhrifysgol Caerdydd.

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