HC Deb 14 February 1966 vol 724 cc888-91
3. Mr. Woodnutt

asked the Minister of Health if he will instruct the regional hospital boards to reduce the interval between tests in the cervical screening service from five years to three years; and if he will also issue instructions to reduce the age at which tests commence from 35 years to 21 years.

Mr. K. Robinson

The frequency and age range adopted were recommended by my medical advisers as a practical basis for a start to routine screening. Boards have been advised to plan laboratory facilities on this basis. Study of these matters is continuing and I am keeping them under review.

Mr. Woodnutt

I realise the difficulty the right hon. Gentleman is in in providing these facilities so quickly, but may I ask him to look at an article in the Lancet of 29th January, by the Medical Officer of Health for Derby, from which he will see that in the 10 months to 31st October, 1965, of the positive tests taken at Derby no less than 65 per cent. were of women under the age of 35 and 15 per cent. were under the age of 25? Would he consider having tests started at the age of 21 and not 35?

Mr. Robinson

I do not think that those findings conform with the general experience. We take the view that these tests should start where the need is greatest. I am told that the risk of cervical cancer increases considerably after the age of 35, but we shall extend the age range as facilities extend. In the meantime, younger women who wish to have the tests will not be turned away.

Mr. Lubbock

Will the right hon. Gentleman recall that in Orpington we have testing every three years from the age of 25 onwards and that this decision was made with his approval? Will he at least consider lowering the age to 25 if not to 21?

Mr. Robinson

I propose continuing as we have started, but, as I say, my mind is not closed to extending the age range as soon as we have sufficient facilities.

18. Mr. Braine

asked the Minister of Health what progress is being made in establishing adequate facilities in Essex, especially South-East Essex, for the early detection of cervical cancer.

The Parliamentary Secretary to the Ministry of Health (Mr. Charles Loughlin)

There has been good progress towards the establishment of a cervical cancer screening service in Essex. Diagnostic facilities for women with symptoms are fully available and screening of women without symptoms should have started in all areas by the spring. In South-East Essex a service for women without symptoms has already started and is to be expanded.

Mr. Braine

I appreciate what the hon. Gentleman has said, but as the difficulty here as elsewhere in the country seems to be a shortage of technicians for the initial screening, will the hon. Gentleman kindly inquire into whether the facilities for training in our hospitals are adequate—I have reason to believe they are not—and whether the conditions of pay and service for attracting these technicians are adequate, and will he ask his right hon. Friend to look into the admirable Brighton cancer project to see whether that example can be followed elsewhere in the country?

Mr. Loughlin

My right hon. Friend is studying the Brighton project, but—and I think that the hon. Gentleman appreciates this—one of the drawbacks to the full extension of this service, though not in recent months, has been the whole issue of training sufficient personnel. We think that there has now been real progress in the enrolment and training of the personnel, and while we are not supremely optimistic, we think that we are making the right kind of progress.

32. Mr. Geoffrey Lloyd

asked the Minister of Health what facilities are available in the Birmingham region for cervical cancer tests; and what factors are delaying full facilities for the screening of women of 35 years of age or over.

Mr. Loughlin

Diagnostic facilities are available in the region for all women with symptoms. There is a partial service for screening other women in over two-thirds of the region. The main impediments to a full service are lack of laboratory space and of technicians trained in cytology; both are being remedied as fast as possible.

Mr. Lloyd

Is the Minister aware that in my constituency the Standing Conference of Women's Organisations is expressing considerable anxiety about this matter, especially since many patients seeking this test have been advised to come back in six months? Will he press on very fast with the development of electronic scanning devices?

Mr. Loughlin

We are aware that deficiencies exist in this service in this region. My right hon. Friend has urged the board to push on with the service as fast as possible. As for the last part of the right hon. Member's supplementary Question, I am not too sure that this could be done at present.

41. Dame Joan Vickers

asked the Minister of Health whether he will state Her Majesty's Government's present policy in regard to the provision of cervical tests for cancer for women; and what advice he has given to hospital boards and local authority health committees in regard to this matter.

Mr. K. Robinson

Our aim is to make routine screening available to all women at risk, starting with those aged 35 or over, at five-yearly intervals. Hospital authorities have been asked to expand facilities for cytology in hospital laboratories to support this service. Sufficient trained laboratory staff are now becoming available to allow routine screening to start in most areas and I am preparing further detailed guidance for all health service authorities on the organisation and development of a full-scale service.

Dame Joan Vickers

While thanking the Minister for that reply, may I ask him to consider the problem in relation to women under the age of 35? A small committee, of which I am chairman, has discovered that 80 per cent. of the women found to have positive symptoms are under the age of 30.

Mr. Robinson

I referred to this matter in answer to an earlier supplementary question. I will look at this evidence, but all the indications which I have received from my medical advisers suggest that the risk rises steeply from the age of 35. Although the hospital returns for December are not yet complete, those available suggest a 25 per cent. increase at least over the June rate of 51,000 women tested per month.

Mr. Fisher

Is the right hon. Gentleman aware that many women have to wait months before they can obtain appointments for tests in a hospital and that this delay is sometimes literally a matter of life and death? Can he do anything further to improve the position in this very important respect?

Mr. Robinson

There should be no delay for women with symptoms, which is the category suggested by the phrase "a matter of life and death". I accept that the development of the service is not uniform over the entire country but we are doing our very best to bring up the more laggard areas at any rate to the average as quickly as possible.