HC Deb 22 February 1972 vol 831 cc1073-7
1. Mrs. Sally Oppenheim

asked the Secretary of State for Social Services what plans he has to extend the screening services for cancer of the breast in the Gloucester area.

15. Dr. Stuttaford

asked the Secretary of State for Social Services when he hopes to have the report of the Committee, set up by himself, to inquire into the early detection of cancer of the breast.

33. Mr. James Hill

asked the Secretary of State for Social Services what plans he has in hand to extend the services at present being privately financed for the screening of cancer of the breast to the National Health Service, with particular reference to the Southampton area.

41 and 77. Mr. William Price

asked the Secretary of State for Social Services (1) how many facilities are available in Rugby for the screening for cancer of the breast;

(2) what women were given screening tests for cancer of the breast in Rugby during 1971.

57. Mrs. Joyce Butler

asked the Secretary of State for Social Services if he will now make further public funds available for breast cancer screening clinics; and if he will make a statement.

75. Mr. Pavitt

asked the Secretary of State for Social Services if he will now take steps to extend the units available in the National Health Service capable of screening women to give an early diagnosis of breast cancer by mammography and clinical examination; and if he will make a statement.

The Under-Secretary of State for Health and Social Security (Mr. Michael Alison)

The principal source of information on the value of pre-symptomatic screening for breast cancer is a study currently in progress in New York. The results so far available are not conclusive and it would therefore be premature to consider introducing a breast cancer screening service within the National Health Service, and further assessment is necessary. It is too early to say when the expert committee I have appointed for this purpose will report.

Clinical examination of the breast or instruction in self-examination, or both, are offered to women at a number of local authority clinics when cervical smears are taken. This is done in clinics in Gloucester and Southampton, but not at Rugby.

Mrs. Oppenheim

Is my hon. Friend aware that in 1970, which is the latest year for which I have figures available, 2,651 women were screened by Gloucestershire County Council Health Department, 1,072 women were screened by Gloucester City Health Department and more than 2,743 women were screened by the Staywell Mobile Clinic, which is a voluntary organisation receiving only a small grant from the county authority. In view of the excellent service that this valuable organisation provides, will my hon. Friend urge his right hon. Friend to make a substantial Government grant?

Mr. Alison

The making of grants to voluntary bodies performing at local level is a matter for the local authorities concerned. In view of the interest which Gloucester is showing in this matter, I imagine the local authorities will look with some sympathy towards this voluntary organisation.

Dr. Stuttaford

Is my hon. Friend aware that the New York study, of which he speaks rather disparagingly, has shown that early detection of carcinoma of the breast has halved the death rate? Is he aware that this figure has been borne out by other centres in the world and that there is a danger that in this country women will die while doctors quarrel—and that his Department seems to be getting involved?

Mr. Alison

My hon. Friend will note that the sponsors and managers of the New York experiment themselves take a note of cautious optimism, a course which is advocated by the World Health Organisation in its recent report on mass health examinations.

Mr. Price

Is the hon. Gentleman aware that he is not as helpful in this matter as he often is in others? Can he give figures to show how many women are having examinations privately? If those figures are as high as we expect, will he ensure that in due course equal facilities are available under the National Health Service for those who need them?

Mr. Alison

I cannot give the hon. Gentleman the figures he is seeking for the obvious reason that we do not collect these figures. As to extending the service to the National Health Service, that turns upon a conviction that the screening procedures would be a net beneficial asset and not, possibly, a liability.

Mrs. Butler

In view of the need to expand the present breast cancer screening facilities so that they are available to all women who are at risk, will the Minister say something a little more encouraging about what his Department is doing to resolve the problem?

Mr. Alison

We are looking at this question with the utmost seriousness, and, indeed, hopefulness, but the hon. Lady I am sure appreciates that there is the possibility of a real hazard here. False positives and false negatives are only too frequent occurrences in these procedures, and real hazards exist which it would be improper for my Department to ignore in the interests of hastening too rapidly.

Mr. Hill

What plans has my hon. Friend to keep the Royal Marsden clinic going, since it already has five years' experience in this subject?

Mr. Alison

My hon. Friend may be aware that a special group under Professor McKeown studying breast cancer screening services is considering whether the facilities at the Royal Marsden clinic may be used as part of this study. No decision on this matter has yet been taken.

Mr. Pavitt

Will the hon. Gentleman not make a clean breast of it and confess that his Department is being overcautious? Does he recall that although the New York fluoridation experiments took place in 1951, it is now 1972 and we have still not succeeded in that matter? Therefore, will he take the initiative and use the peripatetic services at his disposal, such as mass radiography and blood transfusion, in a move towards more preventive services, and include within them mammography?

Mr. Alison

The hon. Gentleman will appreciate that the New York scheme is not yet complete. We shall have to discover whether the initially positive and helpful results ascertained in a particular age group will persist beyond the short term.

Sir R. Cary

Do I understand my hon. Friend to say that the Government cannot give any direct aid to the voluntary organisations mentioned by my hon. Friend in his original Question?

Mr. Alison

The position is that my Department gives help to voluntary organisations in their national activities through their central organisations, but their local activities—and bodies which exist only at local level—are matter[...], for support by local authorities.

Dr. Summerskill

Would the hon. Gentleman accept that his reply is extremely disappointing since it was hoped that this Government would show more sympathy towards preventive medicine and to diagnosis before cure? Would he accept that it is a fact that 10,000 women a year are dying from breast cancer—thousands more than die from cancer of the cervix of the womb? Will the Government, who have shown commendable energy and interest in cytology screening services, keep a close eye on the situation and change their mind at an early date?

Mr. Alison

The hon. Lady will appreciate that we do everything necessary in terms of diagnosis. It is the treatment or screening of pre-symptomatic conditions with which we are here concerned, and uncertainty in this respect imposes on us a proper caution. But the positive approach we have adopted is illustrated by the appointment of Professor McKeown's study group which we hope will work towards a positive end.