HL Deb 07 February 1963 vol 246 cc699-702

3.11 p.m.

LORD TAYLOR

My Lords, I beg leave to ask the Question which stands in my name on the Order Paper.

[The Question was as follows:

To ask Her Majesty's Government how many hospital pathological laboratories within the National Health service have full-time consultants; and how many centres are now available for exfoliative cytological detection of cervical cancer.]

THE PARLIAMENTARY SECRETARY, MINISTRY OF HEALTH (LORD NEWTON)

My Lords, on the 1961 figures, the last available, there were 730 pathological laboratories in England and Wales and 403 whole-time consultant pathologists, many of them supervising more than one laboratory. Over 150 pathological laboratories are examining smears. Of these, 40 examine 100 or more a month.

LORD TAYLOR

My Lords, I thank the noble Lord for this figure. Will he do all he can to encourage those other 300 or 400 pathological laboratories who do not have this technique to carry it out?—because by this means it will be possible to reduce greatly the death rate from a particularly unpleasant form of cancer.

LORD NEWTON

My Lords, the use of this method of detection is growing, and my right honourable friend is encouraging hospital authorities to develop this service.

BARONESS SUMMERSKILL

My Lords, does the noble Lord know that many authorities refuse because they have not enough pathologists? Is he aware that many pathologists say that this technique is quite simple; and they could teach young doctors? There are many women doctors available for part-time work. Could not the noble Lord consider encouraging pathologists to teach some of these women to carry out this technique and ultimately save the lives of many women?

LORD NEWTON

My Lords, the fact is that at the moment not all members of the medical profession have quite as much belief in this method of detection. As I say, my right honourable friend is encouraging hospital authorities to develop this service, but I am advised that use of this method is still in its experimental stage.

LORD TAYLOR

My Lords, further to my noble friend's supplementary question, I think it is past its experimental stage, as shown by the fact that his own Department are encouraging it. The trouble with the method is that it is consuming of pathologists' time. Would the noble Lord ask his right honourable friend to give serious consideration to my noble friend's suggestion?—because the problem, as I understand it, is the shortage of pathologists' time; and that problem could quite easily be overcome, provided that the necessary money was spent in training women doctors, who would otherwise not be working in this life-saving technique.

LORD NEWTON

My Lords, of course I will pay attention to what has been said, but my advice, which I accept, is that this method of detection is still in its experimental stage; and it is also the fact that some people are keener than others about it.

BARONESS SUMMERSKILL

My Lords, this is very important in the field of the prevention of cancer. Does the noble Lord not recall that, either just before the Summer Recess or just after it, when we had a debate on some subject allied to medicine, I asked him what he was doing about this, and he agreed that it was very important? Not for one moment did he then suggest that there was any doubt as to the effectiveness of this method, and he promised me that he would press in the right quarters to see that this was done all over the country.

LORD NEWTON

My Lords, this is a highly technical matter and I have to rely on the medical advice given to me by my Department, and I consider it very good advice. What I am told is that cytology is only one of the factors involved in making a definitive diagnosis, and I understand that it cannot of itself be relied upon to give a firm answer one way or the other.

LORD STONHAM

My Lords, will the noble Lord have regard not merely to the particular question of cytology in considering my noble friend's supplementary question, but also to the fact that there are only four consultant pathologists in the seven pathological laboratories, and that there is also a great shortage of deputies and assistants. Therefore, in the general sense, the suggestion that has now been made might well operate to fill a gap that is very badly felt in pathology.

LORD NEWTON

My Lords, I take note of that point also, but it is a rather different matter from that on which I have been questioned up to now.

LORD TAYLOR

My Lords, with respect, it is true that there are a few people who do not believe in cytological methods of early detection of cancer, but the enormous majority believe it; and if the noble Lord refers to his own monthly bulletin, that of the Ministry of Health for December, 1961, he will find the matter extensively discussed and, on balance, supported. The evidence that it is supported is that it is his own Ministry who are supporting it.

LORD NEWTON

My Lords, certainly we are supporting it, and that is what I said in one of my first supplementary answers. But it was put to me by the noble Baroness, Lady Summerskill, that the support we were giving was not strong enough. In reply to that I pointed out that according to my information, there is not yet complete agreement in the medical profession about this method of detection.

LORD TAYLOR

My Lords, I am sorry to keep pressing at this, but it really is important. The situation is that many pathologists are very willing to do it, but they have not the time, or they say they have not the time; and some have even said that if this were paid for as a supplementary service, a category 2 service, they would be prepared to do it. Really, something ought to be done about this, and, indeed, I respect the Ministry for doing quite a lot. But it is a matter of saving many lives per year. It is a laborious job. I hope that the noble Lord will be a little more pressing with his right honourable friend to get the thing moving quickly.

LORD NEWTON

My Lords, again I have listened with respect, as I always do, to what the noble Lord, Lord Taylor, says, but he is a member of the medical profession and I am not. I have found that one sometimes gets different advice from different members of the profession. I do not think I can add anything more.