National Screening Programmes (Hansard, 24 June 1997)

§ 10. Liz Blackman
To ask the Secretary of State for Health what proposals he has for improving the reliability of national screening programmes. [3475]

§ 16. Laura Moffatt
To ask the Secretary of State for Health if he will make a statement about the breast cancer screening programme. [3482]

§ Mr. Dobson
Breast and cervical cancer screening remain the best method of detecting breast and cervical cancers early so that women can get treatment as quickly as possible. It is vital therefore that women can be confident about the quality of that screening. That is why everyone is so disturbed by the record of failure in breast cancer screening in East Devon NHS trust and in cervical cancer screening in Kent and Canterbury NHS trust.
Arrangements have already been set in train for the chief medical officer to conduct an inquiry into what has been happening in east Devon. At my request, Sir William Wells, the chair of South Thames regional office, has set up an independent inquiry into the lamentable failure of the cervical cancer screening services in Kent and Canterbury, and the equally lamentable failure of the management to deal with the situation. He has accepted the resignation of the chair and chief executive.

§ Liz Blackman
1 thank my right hon. Friend for his answer, which will give great reassurance to many women. A significant number of women in the target groups do not take up invitations to go for screening. The figure varies between 16 and 34 per cent. in different health authorities. Those women do not come forward for a variety of reasons: they lead busy lives, work anti-social hours or do not regard themselves as a high priority. Does he have proposals to encourage such women to come forward to take advantage of the screening programme?

§ Mr. Dobson
As I think my hon. Friend knows, the target take-up rate for breast cancer screening nationally is 70 per cent. of women in target age groups. That is exceeded in every region except North Thames, but that figure does not apply to quite a lot of women in badly deprived areas or to substantial numbers of women among various ethnic groups. I have asked that special measures be taken both in North Thames and in other areas to lift the take-up rate in such groups. I have also asked officials to consider whether the 70 per cent. target is reasonable.

§ Laura Moffatt
In Crawley, ethnic groups form about 10 per cent. of the population. For all sorts of reasons, women in those groups do not come forward. They may have problems understanding what the test is about and be worried about the people who will deal with them if they do come forward. I am thrilled that my right hon. Friend is keen to examine the issue of getting people to 664 breast screening programmes. Is there any way that we could talk to the voluntary organisations that deal with the different ethnic groups about the language that is used and the way in which screening is done? The plans that he mentioned were great, but we need to consider how we get people to come forward.

§ Mr. Dobson
I support the propositions that my hon. Friend puts forward, both from her political knowledge and from her professional knowledge as a nurse. Speaking as one privileged to represent the Elizabeth Garrett Anderson hospital, I can say she might have added that, for some ethnic minority women, a guarantee that they would be dealt with by women would undoubtedly help to raise the take-up rate.

§ Mr. Baldry
The right hon. Gentleman has talked about shifting resources from elsewhere in the NHS to breast cancer. There has been much rhetoric about red tape, bureaucracy and reviews. Can he make clear what reviews are taking place in the NHS? What are their timetables? When will work be completed? Will he give an undertaking that their results will be transparent, so that we shall be able to compare what the Government say about NHS bureaucracy with what is there now to manage a system that spends £42 billion a year?

§ Mr. Dobson
For a start, £10 million has been shifted into breast cancer treatment. That is half the sum saved by not proceeding with the eighth wave of fundholding: £20 million of the NHS budget had been earmarked for the paperwork of the additional wave. It has been shifted not from anything useful but into something useful. I would have hoped that everyone would welcome that. I have made it clear that the chief medical officer's review of screening provision in the south-west, and the review being carried out by Sir William Wells of cervical cancer screening services in Kent and Canterbury, will be reported to me and published.

§ Rev. Martin Smyth
When we think of a 70 per cent. target for take-up, is the other 30 per cent. made up mainly of people in deprived or rural areas? Is there an opportunity to use mobile screening units, as promoted by Action Cancer in my constituency, which go out to where people are so that they do not have to wait to go to specialist centres?

§ Mr. Dobson
Generally speaking, women who are better off and better informed get more screening than women who are worse off and worse informed. Therefore, we have to do everything that we can to target any effort to improve the take-up rate on the worst off and worst informed. Techniques such as the one that the hon. Gentleman has just mentioned and those mentioned by my hon. Friend the Member for Crawley (Laura Moffatt) are all being applied in various parts of the country. I want to see them stepped up because I am not satisfied with the present level of take-up.