Breast Cancer (National Plan) (Hansard, 22 February 1995)

§ Mrs. Alice Mahon (Halifax)

I beg to move, That leave be given to bring in a Bill to require the Secretary of State to formulate a national plan for combating breast cancer. The incidence of breast cancer in the United Kingdom is the highest in the world. Government statistics show that each year there are 30,000 new cases. There are nearly 16,000 deaths from breast cancer per year, and the United Kingdom has poorer five-year survival rates than any other European country or the United States. Those statistics signal a clear need for action, and that is what my Bill is intended to achieve.

The Bill will require the Government to call a conference to establish a national action plan on breast cancer, based on the plan that is now so successful in America. The conference to formulate such a response there was called by President Clinton shortly after his inauguration, following a great deal of pressure which resulted in the presentation to the White House of a petition with 2.5 million signatures. The conference that I want the Government to call must embrace and involve the full spectrum of individuals, groups and organisations concerned with breast cancer.

In America, invitations were extended to 150 representatives—members of advocacy groups, breast cancer sufferers, representatives of private industry, academics, scientists, doctors and people from the media, education and specialist cancer units, as well as many others with a legitimate interest. The action plan that was drawn up at the conference stated: these invited participants worked together in a unique and unprecedented partnership that combined scientific and technical expertise with social insights and personal and professional experience and commitment. I have no doubt that that experience could be repeated here: indeed, we have already seen many exciting new initiatives, such as the launch of the Macmillan breast cancer registry on Monday, and many others.

The United States came up with its plan at about the time when the Army Medical Command diverted $210 million from the defence budget to breast cancer. Thus, the action plan had an immediate budget. Just imagine if we could use some of the money from the Trident programme to help women to combat this dreadful disease. In the United States the political commitment was there, and so was the money. That was very important.

On 14 December last year, the all-party group on breast cancer held a seminar which many eminent professors and medical professionals attended, as did many user groups comprising those connected with breast cancer. The purpose of the seminar was to discuss the merits of a national plan. I believe that it was a huge success, and I pay tribute to all who attended and contributed.

At the end of the seminar, people were unanimous in their support for a national action plan. It should be noted that hon. Members from all parties attended, and that all parties in the House support my Bill.

As I have said, superb initiatives are already under way, and some excellent work is already being undertaken. Much of it, however, is fragmented. As we heard on Monday, services, in particular, are a lottery—the Macmillan document makes that clear.

373 The abolition of the regional health authorities is causing great concern. The British Breast Group recommends access to specialist facilities—it is a keynote of its recommendations—but uncertainty of funding remains. Who will guarantee, for instance, that purchasers will pay for the use of such facilities if they are established?

The document produced in the United States of America is a blueprint drawn to highlight opportunities to advance and apply knowledge about the causes, diagnosis, prevention, treatment and ultimate eradication of this dreadful disease. That document has acted as a catalyst in co-ordinating actions relating to breast cancer. There is no reason why we cannot do the same here.

The first part of such a plan would concentrate on improving access to services. That is at the core of British Breast Group's report, which is clear in its demands. It says that all patients with breast disease should have access to high-quality care. The characteristics of such care should include accurate and timely diagnosis, appropriate treatment and follow-up, effective communication, skilled psychosocial support, immediate access to other specialist facilities as required, and collection of data on outcome measures.

The importance of improving co-ordination and information management among providers cannot be overstated. It is also vital to increase participation of under-served and at-risk populations in breast cancer programmes dealing with risk factors. Early detection, diagnosis and treatment are essential. That would mean targeting and working with educationists and the media, which would be important if the Government were to adopt a national strategy.

Part two of a national plan should involve research into the causes and cures of breast cancer. That research must be properly funded. I would make the same demands of a Labour Government, were they in power.

In the United States, the following plan was put into operation. It aims to identify and to foster promising new areas of basic research through interagency, inter-disciplinary and private and public collaboration; to facilitate collaboration among basic, clinical behavioural, epidemiological and health services, plus scientists across the disciplines—which has been successful in some ways; and to organise and support multi-disciplinary research and collaborative efforts, using a wide range of mechanisms that maximise individual and group efforts.

Part three of the national plan would, as in the United States, establish comprehensive patient data registries and 374 material banks as research tools. That would need national funding. The infrastructure must be put in place; more important, it must be paid for.

Part four of the plan would increase opportunities for research training in sectors related to breast cancer. The United States, for example, is expanding the scope and breadth of biomedical and behavioural research activities relating to breast cancer. It is providing adequate resources and mechanisms to speed the translation from the lab to the clinic of new therapeutic opportunities. It is making clinical trials more widely available to women with breast cancer, and women who are at risk from breast cancer.

At our seminar in December, Alison Coates from Bosom Friends, a Bradford-based support group, commented: I was diagnosed breast cancer at the age of 24. Personally, what I would like to know is what research and trials are taking place to prevent cancer occurring in women outside the screening age group. I have not been invited to take part in any clinical trials, although I have put myself forward on numerous occasions. My plan would utilise such women, who want to take part in finding the causes of breast cancer.

Most important, the United States is supporting research on the prevention of the causes of breast cancer. Clearly, we need to persuade the Government that a national action plan is necessary. That means picking up the bill for research, and not leaving it to the charities. There is a serious need to support and fund clinical trials, and to support an infrastructure. The British Breast Group has made many recommendations that should be implemented, as has the Calman and Culyer report.

I give the final word to a 32-year-old woman from Bosom Friends in Bradford, Sue Patterson, who told the seminar held by the all-party group that, after suffering this dreadful disease, she was told in follow-up advice to lie on her back and think of England. She told us: I am thinking of England and we do have a public voice. Women are coming forward. We are prepared to be mobilised. We are prepared even to go on the streets. We really do feel we are being forgotten, that is why we call upon this Government to establish a National Plan of Action on Breast Cancer.